Interest form

Before & After School Care Interest Form

Our program provides a safe, engaging, and enriching environment where students receive academic support, participate in fun enrichment activities, and build the skills they need to succeed. Please complete the form below — we will follow up with enrollment information.

Parent / Guardian Information

Parent / Guardian name *

Phone number *

Email address *

Home address *

City *

State *

Zip *

Preferred method of contact

PhoneTextEmail

Student Information

Student name *

Grade (2026–2027 school year) *

School attending *

Student date of birth *

Programs of Interest

Please select the program(s) you are interested in

Before School Care – $200 per monthAfter School Care – $220 per monthBefore & After School Care – Discounted Monthly Rate AvailableCamp – TBA

Payment & Referral

How do you plan to pay for services? We proudly accept Child Care Vouchers

Private PayChild Care Voucher/ScholarshipOther

If other, please specify

How did you hear about Beyond the Bell?

Beyond the Bell 4.0 Experience

📞 410-417-7406 · 🌐 4PTBTB.com

Thank you for your interest in Beyond the Bell, a 4.0 Experience!

4.0Beyond the Bell

A safe, joyful, and educational before & after-school program for ages 5–13.

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Get in touch

(410) 417-7406
beyondthebell@4ptbtb.com
Mon–Fri • Before & After School