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Tip: A new application is required for the new school year. Once an application is created for the current school year, use the Update an Existing Registration button to update a registration.

Extended Learning Opportunities Program (ELOP) Registration

Please select your school below

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Does your child have a Broward Student ID?

It's 10 digits and starts with 06

Student Information

Please tell us about your child

FSI/Student ID

Home School

Teacher Name

Grade

Student First Name

Student Last Name

Requested Starting Date

DOB

Race

Child lives With

Hair Color

Eye Color

Gender

Height

List all siblings attending and/or applying for this program:

(Note: A separate application is required for each child. You will have the opportunity to complete a separate application for each sibling. After you finish this application and click the submit button, you will receive a confirmation. This is where the "Add Sibling" button will be displayed.)

Are you a current BCPS employee?

Please answer below

Parent/Guardian 1

Please tell us about the Parent/Guardian 1 for this student

First Name

Last Name

Primary Address

City

State

Zip

Cell Phone

Home Phone

Work Phone

Cell Phone Provider

Parent/Guardian 1 Password

Add a Parent/Guardian 2 (optional)

I permit my child to be photographed or videotaped for program events and acitivites?

Please answer below

Authorized Release/Contact for Parent / Guardian 1

Please list all contacts & authorized release for Parent/Guardian 1 ( )

Do not include Parent / Guardian 1 and Parent / Guardian 2, as listed on the application

Authorized Release/Contact 1

First

Last

Relationship

Work/Cell Phone

Home Phone

I declare this information to be true and correct. I will notify the Supervisor immediately of any changes.

I agree that my electronic signature is legal and binding. It is equivalent of my handwritten signature:

Signature

Relationship

If I cannot be reached, I/we hearby authorize contact with, release of emergency related information, or release of the student to the following persons in the event of illness, evacuation, or other emergency that may occur while the student is in the program. Medical and other information will be disclosed without consent from the parent/eligible student in case of health emergencies, as permissible by the Family Educational Right and Privacy Act (FERPA). The programm will call for emergency medical care as deemed necessary. Emergency transportation to a health care facility, as determined by paramedics, will be authorized.

Ready to submit application?

Please submit below

Registration Submitted!

We have received your registration

A confirmation email will be sent to the email address listed on the registration.

Need to add a sibling with the same information?

Thank you for updating registration. The Application # is . Please come back when additional changes need to be made to an existing registration.