Enroll Now | Beyond Expectations

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Pre-Enrollment Form

Child's Name

Date of Birth

Age

Email

Address

Phone Number

Preferred Language

Parent/Guardian Name

Diagnosis of Child

Does your child receive medication?

Does your child receive therapies?

If yes, please list therapies and therapy center

Child's insurance plan

Current School

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Beyond Expectations Academy

Contact us:

10920 SW 184th Street

Cutler Bay, FL 33157

(305) 378-5775

info@beyond-expectations.org

©2023 by Beyond Expectations Academy

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