Junior Program FALL PAYMENT

Junior Program Descriptions

On-line PAYMENT for the Pass Academy Junior Programs at the Bullis School (Step 2 of 2)

Only use this form if you have filled out a Junior Program Application and have received approval from the office, and were requested to make payment in order to secure the student’s spot in the requested/recommended session.

  • Junior Program PAYMENT Form
    2024 Fall

     
  • Approval from the Pass Academy office is required before using this program Payment Form.
  • Please enter a number from 5 to 18.

  • Parent Information

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  • Junior Program Options

    Fall: 9/3/24 - 10/27/24 (No classes on 10/14)

  • $0.00
  • American Express
    Discover
    MasterCard
    Visa
    Supported Credit Cards: American Express, Discover, MasterCard, Visa
      

  • Medical Authorization & Release

  • MM slash DD slash YYYY
    By signing below, in an emergency, when I/we cannot be contacted, I/we hereby authorize the staff of the Pass Academy to take my/our child to the emergency room of the nearest hospital. I/we authorize that hospital and its medical staff to provide treatment deemed necessary for the well-being of my/our child.
  • MM slash DD slash YYYY
    By dating above, I agree to hold the Pass Academy and Bullis School harmless for injury or loss that may occur as a result of my participation in Pass Academy activities.
    I give permission for photos of my child participating in Pass Academy at Bullis programs to be taken and used for the Pass Academy Website and/or Facebook page. We understand that if students are identified, only their first names will be used.