After School Registration - Be Elite Academy

Be Elite Academy""Our programs are designed to be inclusive and representative of the diverse communities we serve, ensuring that every child feels a sense of belonging. We believe that our culture is one of collaboration, continuous improvement, and a steadfast focus on the safety and well-being of the youth in the communities that we serve.""

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AFTER - CARE REGISTRATION CONTRACT

Be Elite Academy at Las Cruces Catholic School

Student Name *

First

Last

Age *

Grade *

Grade for the 2026 - 2027 School Year

Date of Birth *

Student Name (optional 2nd child)

First

Last

Age

Grade

Grade for the 2026 - 2027 School Year

Date of Birth

Parent Email Release

Student Name (optional 3rd child)

First

Last

Age

Grade

Grade for the 2026 - 2027 School Year

Date of Birth

Student Name (optional 4th child)

First

Last

Age

Grade

Grade for the 2026 - 2027 School Year

Date of Birth

Name of School Children Are Attending

Parent/Guardian Name *

First

Last

Parent/Guardian Email *

Parent/Guardian Phone *

Parent/Guardian Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

2nd Parent/Guardian Name (optional)

First

Last

2nd Parent/Guardian Email

2nd Parent/Guardian Phone

2nd Parent/Guardian Mailing Address

Address Line 1

Address Line 2

City

State

Zip Code

EMERGENCY CONTACT: *

NAME

PHONE: *

RELATIONSHIP *

AUTHORIZED INDIVIDUALS TO PICK UP CHILD:

NAME: *

PHONE: *

RELATIONSHIP *

2nd NAME:

Optional

PHONE:

RELATIONSHIP

3rd NAME:

Optional

PHONE:

RELATIONSHIP

After-Care PAYMENT PLANS

*After-care program tuition will be billed monthly based on the number of days your child is enrolled each week (this will be calculated based off of attendance).

*10% discount applies for each additional child enrolled.

*Note* School Holidays/No School Days - $25.00/Daily

ECECD CONTRACTS (participating in the New Mexico Child Care Assistance Program)

YES - $0.00

Sports Leagues are Included with all ECECD Participants

BEFORE/AFTER SCHOOL

Daily - $15.00

AFTER SCHOOL

Daily - $12.00

BEFORE SCHOOL

PER MORNING - $5.00

SPORTS LEAGUES

SOCCER - $100.00
BASKETBALL - $100.00
FLAG FOOTBALL - $100.00

I Understand That: (Please Initial) *

A fee of $25.00 will be charged for a returned check returned for any reason.

I Understand That: (Please Initial) *

A fee of $2.00/day will be charged for accounts delinquent 7 days after the statement due date. Any fees not paid within 15 days of statement will result in suspension of After-School services, until fees are paid. After 30 days After-School care services will be terminated.

I Understand That: (Please Initial) *

Registration forms need to be completed before child can start the program.

I Understand That: (Please Initial) *

A late fee of $5.00 will be added if child is picked up five minutes after 6:00pm. $1.00 will be added for each additional minute after 6:05pm until child is picked up. Recurring late pickups will result in disenrollment.

I Understand That: (Please Initial) *

Electronic devices will not be allowed in the After-School program unless approved by the Director. The After-School program is not responsible for the loss of any electronic devices or outside personal belongings.

I Understand That: (Please Initial) *

I have read the parent/child handbook and understand the policies and procedures. The Parent/Policy Handbook is available on the Be Elite Academy After-Care Program website page.

GUARANTOR INFORMATION:

NAME *

First

Last

PHONE *

ADDRESS *

Address Line 1

Address Line 2

City

State

Zip Code

PLACE OF EMPLOYMENT: *

DATE OF BIRTH (DOB) *

EMAIL *

I agree to the payment plan selected above and I am aware that all services will be paid on or before the due date. *

Electronically Signed By (Signature of Parent or Guardian)

Date *

PHOTOGRAPH RELEASE: *

YES
NO

I release Las Cruces Catholic School After-School Program to photograph and/or videotape my child/dren while
participating in daily activities, and to use the photographs and/or videos in photograph displays, program website or
other publications showing these activities.

Photograph Release Signature (if checked YES)

/s/ Electronically Signed By (Signature of Parent or Guardian)

MEDICAL INFORMATION:

Name of child’s physician or clinic:

Physician or clinic address and phone:

Name of Medical Insurance:

Special physical conditions/ Medical / Allergy Information we should be aware of:

MEDICAL INFORMATION: I/WE, *

Applicant/s name/s

,hereby give permission that my child(list name/s), *

may receive emergency treatment, to include first aid and CPR by a qualified staff member of Las Cruces Catholic School After-School Program. I further authorize and consent to medical, surgical, and hospital care, treatment, and procedures to be performed by my child’s regular physician, or when the physician cannot be reached, by a licensed physician or hospital when deemed immediately necessary or advisable by the physician to safeguard my child’s health if I cannot be contacted. In such a case, I waive my right of informed consent to such treatment. I also give permission for my child to be transported by ambulance or aid car to an emergency center for treatment. I further authorize Las Cruces Catholic School After-School Program to take my child to a hospital and I agree that I will pay all physicians and hospital bills, and said center shall not be responsible for them.

Electronically Signed By (Signature of Parent or Guardian) *

/s/

Date *

BE ELITE ACADEMY / LAS CRUCES CATHOLIC SCHOOL

AFTER-CARE PROGRAM DISCIPLINE POLICY

Dear Parents,

The following are requirements of the Child Care Licensing Bureau, please read carefully and sign and date below, that you understand the outlined disciplinary practices and that you agree with them.

SERVICES AND CARE OF CHILDREN

Discipline means training that enables the child to develop self-control and orderly conduct in relationship to peers and adults. Discipline shall be clear and understandable to the child, consistent and explained to the child before and at the time of any disciplinary action. Discipline shall include positive guidance, re-direction and the setting of clear-cut limits, which foster the child’s own ability to become self-disciplined.
Positive discipline may include brief, supervised separations from the group or withdrawal of special privileges such as playtime with the other children.The following disciplinary practices are prohibited in facilities licensed pursuant to these regulations:
-Physical punishment of any type.
-Withdrawal of food, rest or bathroom opportunities.
-Abusive or profane language.
-Any form of public or private humiliation, including threats or physical punishment.
-Unsupervised isolation of child.
Any other type of punishment that is harmful to the physical, emotional and mental health of the child.
I have read and understand the above disciplinary practices put forth by the Licensing Bureau of New Mexico. I agree that the above disciplinary practices should be implemented by the Be Elite Academy Extended Care program. Any violations of BE ELITE ACADEMY / LAS CRUCES CATHOLIC SCHOOL AFTER-SCHOOL DISCIPLINE POLICY may result in the suspension or termination of the registered student at the discretion of the director.

During the After-School program your child will be involved in different activities and groups while in our care. For this reason you child will be asked to put away their electronic device or leave it at home. Your child be allowed to use their electronic device during designated times as assigned by staff. Be Elite Academy along with Las Cruces Catholic School After-School is not responsible for broken, lost or stolen items.

Electronically Signed By (Signature of Parent or Guardian) *

/s/

Date *