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  • BEAR Witness Online Registration
  • Fill out the following for the Child participant...
  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Grade Entering for the 2021-2022 School Year REQUIRED Please fill out this field. Please enter valid data.
  • Gender REQUIRED Male Female Please fill out this field.
  • Date of Birth REQUIRED Please fill out this field. Please enter a date.
  • Allergies Please enter valid data.
  • Medical Concerns Please enter valid data.
  • Comments Please enter valid data.
  • Now please fill out the remainder of this form in regards to the Parent.
  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • Address 1 REQUIRED Please fill out this field. Please enter valid data.
  • Address 2 Please enter valid data.
  • City REQUIRED Please fill out this field. Please enter valid data.

    State REQUIRED AK AL AR AS AZ CA CO CT DC DE FL GA GU HI IA ID IL IN KS KY LA MA MD ME MH MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA PR PW RI SC SD TN TX UT VA VI VT WA WI WV WY Please fill out this field.

    Zip REQUIRED Please fill out this field. Please enter a zip code.
  • Contact Phone Number 1 REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Contact Phone Number 2 REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Emergency Contact Name REQUIRED Please fill out this field. Please enter valid data.
  • Emergency Contact Relationship REQUIRED Please fill out this field. Please enter valid data.
  • Emergency Contact Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Alternate Pickup Name REQUIRED Please fill out this field. Please enter valid data.
  • Alternate Pickup Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.

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