Program Registration

Parent/Guardian First Name Parent/Guardian Last Name Email Additional email to receive updates about this course (optional) Primary Phone Secondary Phone (optional) Address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas Armed Forces Europe, the Middle East, an Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Territory Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Zip - Zip Suffix Where does the student go to school? What is the student's ethnic background? American Indian or Alaska Native Asian Black or African American Hispanic Middle Eastern or North African Multiracial Native Hawaiian or Other Pacific Islander White Other Prefer not to say What is the student's gender identity? Female Male Nonbinary Transgender Other Prefer not to say Does the student have a disability? Yes No Prefer not to say How would you describe your family's income status? Low income Lower-middle income Upper-middle income High income Prefer not to say How many students are you registering for this program? Photo Release: I, the parent or guardian, agree to allow the use of my child’s photo, video images, and/or audio recordings in which they can be heard for the promotional needs of BAAY and its affiliated programs. I agree that all such images and recordings are the sole property of BAAY. No names of students will be listed. If you have a coupon, please enter code here (case-sensitive):