New Registrations:
Please remember to download and complete all forms.
Download All Forms

Tuition Assistance is available for qualifying families.
All confidential inquires should be mailed to:
Carol Cipriano
c/o The BAS Program
P.O. Box 1121
Middlebury, CT 06762
Click here for a Tuition Assistance Application

The Region #15  Before and After School Program, Inc.

984 Southford Rd.

Middlebury, CT

Phone: 203-758-9799

Fax: 203-758-9799

E-mail:bas@region15bas.org

The Region #15 Before and After School Program
BAS Forms for Download

For more information on what forms you need or additional information for registration, please contact us at

registration@region15bas.org

BAS Parent Handbook 2011-2012
Parent Agreement Form
Child Release Pick Up Form
Early Dismissal Form
Emergency Medical Authorization Form
Health Assessment Record
Non BAS Activity Particpation Form
Pomperaug Region 15 School District Alternate Transportation Form
Note: This form is located at the Region 15 website and is downloaded from there.