Byram Hills Preschool Association Membership 2010-2011
Send in Your Membership Dues Today
The Byram Hills Preschool Association is a not-for-profit organization established to benefit preschool
age children, their parents and caregivers. With over 300 member families throughout the Byram Hills School
District, we strive to provide an array of social, cultural and educational activities for our members. In
addition, through our fundraising efforts, we offer donations to local community organizations and programs that relate directly
to preschoolers.
Please check out our website at BHPA.info
--------------------------------------------------------------------------------------------------
Please Note: This information will be used in
the 2010-2011 Member Directory
Mom’s Name________________________________Dad’s Name ______________________________________
(first, last) (first, last)
Street Address___________________________________________Town&Zip___________________________
Phone________________________ E-mail ________________________________________________________
Please list all children living at home, even those who are not
of preschool age
Child’s Name
Birth Date
Pre School (if applicable)
____________________
_______________
____________________________
____________________
_______________
____________________________
____________________
_______________
____________________________
____________________
_______________
____________________________
____________________
_______________
____________________________
New Member? Yes_______
No_______
If you moved to the area recently, would you like a “Welcome
Packet?” Yes______ No_______
Would you like to receive community news from “allaboutarmonk.com?” (Email lists
will be kept private.) Yes______No_______
Would you prefer to receive your monthly newsletter via email? Please choose
one: Yes _____ No______
Check here if you want to be contacted for volunteer opportunities within our organization. ______
Are you a working parent?
Yes_______ No_______
Please send your $40 annual membership dues (check made payable to BHPA) along with this
completed form to:
BHPA c/o Sabrina Christiansen
20 Suzanne Lane
Pleasantville, NY 10570
(There
will be a $30 fee charged for all returned checks.)
The Byram Hills Preschool Association (BHPA)
disclaims liability for any injury or damage incurred by a participant (or spectator) in any BHPA activities, including but
not limited to, the annual fall carnival, the holiday parties, the monthly arts and crafts projects and the playgroups.
BHPA members and their invitees assume the risks associated with their presence at all BHPA events. The
BHPA reserves the right to photograph or record members for future promotional use. The undersigned
hereby authorizes the BHPA to use photos taken of me and/or my child/children in any printed or electronic materials issued
by or on behalf of the BHPA, including but not limited to the monthly newsletter, flyers, bulletins, press releases, email
communications and the BHPA website. I also acknowledge that photos may be taken of me and/or my child/children at BHPA
events by members of the media and utilized publicly by the media with or without the consent or input of me or the BHPA.
________________________________________________
____________________________________________________
PRINT
SINGNATURE