Policy Consent Form

POLICY CONSENT FORM
By Checking boxes below, I confirm, I have fully read, understand, and agree to abide by the policies put forth in the following documents:*

Summer Mailout DocumentsAttendance PolicyPolicy Addendums & RemindersDrop Off/Pick Up PolicyDress Code PolicyInternet & Computer Acceptable Use PolicyElectronic Device Use PolicyAcademic Integrity PolicyStatement of FaithParent Sports Code of Conduct (1st-6th grade only)Community Service Program Guidelines (4th-6th grade only)Parent Handbook
In addition, I have completed and submitted the following forms on the Legacy App:
- Parent and School Agreement
- Family Emergency Information
- Family Insurance Information
- Statement of Faith
- Student Athlete Code of Conduct
- Policy Consent Form
- Extended Care Enrollment (if desired)
- Mandarin Chinese Program (if desired)
- Student Medication (if applicable)
Student Information
Student Name*

First NameLast Name
Grade*
Parent / Guardian Information
Parent / Guardian Name*

First NameLast Name
Email Address*
example@example.com
Phone Number
Terms and Conditions
By checking this box I agree to abide by any necessary amendments or additions to the above policies that may be implemented during the course of the school year. I understand that my child’s enrollment is contingent upon the above acknowledgements and completed signatures.
Parent / Guardian Signature*

Clear
Legacy Christian Academy

27680 Dickason Drive
Valencia, CA 91355
Phone: 661.257.7377
Should be Empty:

POLICY CONSENT FORM