Registration

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Parent / Guardian Name* This field is required.
First Name
Last Name
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Phone Number* This field is required.
Area Code
Phone Number
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Parent / Guardian E-mail* This field is required.
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Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
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Please Select
Please Select
Afghanistan
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Student Name* This field is required.
First Name
Last Name
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Student Birthday* This field is required.
Date
Month
Day
Year
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Does your child has any allergies, or special needs requirements? If YES, please explain below so we can better serve your family.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
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HOB+ Enrichment Program Class DescriptionsPlease save a copy or print out and read before completing enrollment.
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PRESCHOOL - Fridays: 9:30am-11:32am* This field is required.Lil' Hobbits Preschool runs through both Session 1 and Session 2. Child must be potty trained and turn 3 during the 2025 school year. For children ages 2.5 - 5 years. Meets on Fridays from August-May.
None
Lil' Hobbits Preschool Supply Fee $65.00 Monthly Cost $75.00
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1st Session Courses - Fridays: 9:30am-10:25am* This field is required.(EE)=Early Elementary (UE)=Upper Elementary (M)=Middle School (H)=High School
None
(EE)(UE)(M)(H) Bal-A-Vis-X (1st Semester) Instructor: Mrs. Laurie Tiemens - Supply Fee $65.00 - Monthly Fee $50.00
(EE) Melody Makers: Music Appreciation (1st Semester) Instructor: Mrs. Heather Sheffer Supply Fee $25.00 Monthly Cost $25.00
(UE)(MS) Hands-On History: New World Explorers (1st Semester) Instructor: Mrs. Lisa Heilenman - Supply Fee $30.00 - Monthly Cost $25.00
(M)(H) Consumer Math (Full Year) Full Year Instructor: Mrs. Laura Lombardo Supply Fee $50.00 Monthly Cost $35.00
(M)(H) Geometry (Full Year) Instructor: Mrs. Tracy Gisselquist Supply Fee $20.00 Monthly Cost $30.00
Nursery
Study Hall
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2nd Session Courses - Fridays: 10:30am-11:25am* This field is required.(EE)=Early Elementary (UE)=Upper Elementary (M)=Middle School (H)=High School
None
(EE) STEM (1st Semester) Instructor: Mr. Alan Lombardo - Supply Fee $35.00 - Monthly Cost $30.00
(UE)(M) Gameschooling (1st Semester) Instructor: Mrs. Heather Sheffer - Supply Fee $25.00 - Monthly Cost $25.00
(UE)(M)(H) Social Emotional Learning (1st Semester) Instructor: Mrs. Laura Lombardo - Supply Fee $35.00 - Monthly Cost $35.00
(M)(H) Cinema as Literature (Full Year) Instructor: Mrs. Laurie Tiemens - Supply Fee $40.00 - Monthly Fee $50.00
(H) Physics (Full Year) Instructor: Mrs. Tracy Gisselquist Supply Fee $20.00 Monthly Cost $30.00
Study Hall
Nursery
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Lunch and Recess: 11:30am-12:30pm* This field is required.Will your student be attending lunch and recess?
No
Yes
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3rd Session Courses - Fridays: 12:30pm-1:25pm* This field is required.(EE)=Early Elementary (UE)=Upper Elementary (M)=Middle School (H)=High School
None
(EE) Fun Themes (1st Semester) Instructor: Mrs. Heather Sheffer Supply Fee $25.00 Monthly Cost $25.00
(EE)(UE) Focus On Elementary Chemistry (1st Semester) Instructor: Mrs. Lisa Heilenman Supply Fee $30.00 Monthly Cost $25.00
(UE)(M)(H) Introduction to Sewing (1st Semester) Instructor: Mrs. Carina Wheat Supply Fee $50.00 Monthly Cost $25.00
(M)(H) The History of Makeup (Full Year) Instructor: Mrs. Melissa Cox Supply Fee $50.00 Monthly Cost $25.00
(M)(H) Practical Survival Skills for Life (Full Year) Instructor: Mrs. Laurie Tiemens - Supply Fee $50.00 - Monthly Fee $50.00
(H) Physics Lab (Full Year) Instructor: Mrs. Tracy Gisselquist Supply Fee $20.00 Monthly Cost $30.00
Nursery
Study Hall
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4th Session Courses - Fridays: 1:30pm-2:25pm* This field is required.(EE)=Early Elementary (UE)=Upper Elementary (M)=Middle School (H)=High School
None
(EE) Learn and Play! (Full Year) Instructor: Mrs. Melissa Cox Supply Fee $25.00 Monthly Cost $25.00
(UE) Upper Elementary Art: Famous Artists (Full Year) Instructor: Mrs. Lisa Heilenman Supply Fee $30.00 Monthly Cost $30.00
(M)(H) Cooking 101 (1st Semester) - FULL - WAITING LIST AVAILABLE
(M)(H) Agree to Disagree: Civil Discourse (1st Semester) Instructor: Mrs. Laurie Tiemens Supply Fee $20.00 Monthly Cost $50.00
(H) Spanish 2 (Full Year) Instructor: Mrs. Kelly Olwell Supply Fee $30.00 Monthly Cost $25.00
(H) Exploring Government (1st Semester) Instructor: Mrs. Laura Lombardo Supply Fee $25.00 Monthly Cost $25.00
Study Hall
Nursery
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5th Session Courses - Fridays: 2:30pm-3:25pm* This field is required.(EE)=Early Elementary (UE)=Upper Elementary (M)=Middle School (H)=High School
None
(EE) Littles Art: Discover Famous Artists (Full Year) Instructor: Mrs. Kelly Olwell Supply Fee $30.00 Monthly Cost $30.00
(UE)(M) First LEGO Challenge (1st Semester) Instructors: Mrs. Lisa Heilenman & Mrs. Tracy Gisselquist Supply Fee $50.00 Monthly Cost $35.00
(M)(H) ASL American Sign Language (Full Year) Instructor: Mrs. Laurie Tiemens Supply Fee $30.00 Monthly Cost $50.00
(H) High School Art: Methods and Mediums (Full Year) Instructor: Mrs. Laura Lombardo Supply Fee $50.00 Monthly Cost $35.00
Study Hall
Nursery
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HOB+ Enrichment Program ManualPlease save a copy or print out and read before completing enrollment.
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I have read and understand the HOB+ Enrichment Program Manual. My family agrees to follow the policies set forth in it.* This field is required.
Yes
No
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Medical & Liability Release FormPlease print out, fill out and mail to: HOB+ Laura Lombardo 6636 Schoolhouse Rd Bealeton, Va. 22712
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I understand that the HOB+ Enrichment Program operates entirely through volunteer efforts. As a cooperative, not a traditional school, active participation from all members is essential. Please fill out the commitment form provided to finalize your registration. Members who repeatedly fail to fulfill their commitments may face dismissal from the co-op. Your involvement is crucial, and we appreciate everyone's contribution.* This field is required.Once you've completed your application, keep an eye on your email inbox for the volunteer commitment form. Remember, enrollment isn't finalized until this form is filled out completely. Thank you for your cooperation, and we look forward to having you as part of our community!
Yes
No
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I release Homeschoolers of Bealeton (HOB+) and Bealeton Baptist Church (BBC) from any and all liability in case of accident, illness or injury during any activities related to or received during participation in the program or on the property thereof.* This field is required.
Yes
No
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I understand that I assume all financial responsibility for any treatment and/or injuries sustained by/to my minor while participating in the program, events and activities. I agree to not hold any of the above mentioned groups liable for any costs associated with medical assistance.* This field is required.
Yes
No
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Terms and Conditions* This field is required.1. Membership Eligibility: By enrolling in HOB+ Enrichment Program, you certify that you are eligible for membership according to the criteria outlined in our bylaws and membership requirements. 2. Enrollment Process: Enrollment in HOB+ Enrichment Program requires completion of the application form and submission of all necessary documentation as outlined in the enrollment process. Enrollment will not be considered complete until all required steps are fulfilled. 3. Volunteer Commitment: As a member of HOB+ Enrichment Program, you agree to fulfill the volunteer commitment outlined by the co-op. This may include participating in committees, assisting with events, or contributing in other capacities as needed. 4. Co-op Fees: Members are responsible for paying all applicable fees associated with enrollment in HOB+ Enrichment Program, including but not limited to membership dues, activity fees, and materials fees. Failure to pay fees may result in suspension or termination of membership. 5. Code of Conduct: Members of HOB+ Enrichment Program are expected to adhere to a code of conduct that promotes a positive and respectful learning environment for all participants. Any violations of the code of conduct may result in disciplinary action, up to and including termination of membership. 6. Attendance and Participation: Members are expected to attend co-op sessions regularly and actively participate in co-op activities. Excessive absences or lack of participation may result in a review of membership status. 7. Liability Waiver: By participating in activities organized by HOB+ Enrichment Program, members acknowledge and accept the inherent risks associated with such activities. Members agree to release HOB+ Enrichment Program and its organizers from any liability for injury, loss, or damage incurred during co-op activities. 8. Changes to Terms and Conditions: HOB+ Enrichment Program reserves the right to amend or update these terms and conditions at any time. Members will be notified of any changes, and continued participation in the co-op constitutes acceptance of the revised terms. By signing below, you acknowledge that you have read, understand, and agree to abide by the terms and conditions outlined above.
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Signature* This field is required.
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