Complete Below Our
On-line Registration Form
UMBA Bright Stars - Beyond the School Day Registration Form

 STUDENT INFORMATION 

 PARENT INFORMATION 

Your relationship to Scholar/Student
Your relationship to Scholar/Student

 Sign-Out Information 

Safety is priority for the “Bright Stars - Beyond the School Day;” therefore, no child enrolled in “Bright Stars” will be released from the program without a parent/guardian signature or that of one of the three individuals below. (Note: The names below must be of someone 16 years or older.)

 

© 2017 by UMBA Bright Stars, Inc. After School Program

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Call Us: 704-579-7642   /   prlborders@aol.com  /  Greater Bethel A.M.E. Church  |   5232 The Plaza   |   Charlotte, NC  28215