CAC Registration Form Online Classes

Christian Academy Of Champions Registration Form
Mother's Name *

First Name Last Name
Father's Name *

First Name Last Name
Person/s child Lives with? *
Email Address *
Student's Name *
Student's Gender *

Male Female
Student's Birthday *
2nd Student's Name
Student's Gender

Male Female
3rd Student's Name
Student's Gender

Male Female
Student's Birthday
Parent Contact Number *
Do you recieve Text at this number? *

Yes No
Address *
City *
Zip Code *
Child's Physician *
Preferred Hospital *
Individuals to contact in case of an emergency in case parents do not answer?
Name

First Name Last Name
Phone Number

Area Code Phone Number
Relationship
Name

First Name Last Name
Phone Number

Area Code Phone Number
Relationship
Media Use Policy and Consent

On occasion, Christian Academy of Champions shall take and publish photos/videos of students and events for use in advertising on the CHRISTIAN ACADEMY OF CHAMPIONS website and on CHRISTIAN ACADEMY OF CHAMPIONS social media.

I (we) grant permission to CHRISTIAN ACADEMY OF CHAMPIONS to take and publish any media that includes my (our) child, without further consideration, and I (we) acknowledge the right of CHRISTIAN ACADEMY OF CHAMPIONS to crop or treat any media at its discretion.

I (we) also understand that once an image is published it may be downloaded by any or all persons with access to CHRISTIAN ACADEMY OF CHAMPIONS' advertising, website and social media. Therefore, I agree to indemnify and hold harmless CHRISTIAN ACADEMY OF CHAMPIONS administration and any agents thereof from any future claims.

CHRISTIAN ACADEMY OF CHAMPIONS reserves the right to discontinue the use of any photos/videos or other media at any time as they deem necessary.

I (we), have read and understood CHRISTIAN ACADEMY OF CHAMPIONS's Media Use Policy and give full permission as required by this Media Consent Form.
Please click yes if you WILL give permission to have photographs of your child(ren) taken *

Yes No Only for my personal update/emails etc.
How did you find us? *

Sign Flyer Google/Other search engine Facebook Friend Other
If you were referred by a friend please let us know who, so we can thank them!
Does your child(ren) have any food Allergies? *
Does your child(ren) have any dietary restrictions? *
Does your child(ren) have any special needs? *
If yes to any of the three questions, please explain.
My child(ren) has permission to be released to the following individuals or transportation services in addition to the emergency contact persons listed above. (please notify all individuals that they may be asked to show proof of identity and we will only release your child(ren) to those listed)
Name

First Name Last Name
Name

First Name Last Name
Name

First Name Last Name
School Health Requirements

In accordance to Kentucky State Law, CHRISTIAN ACADEMY OF CHAMPIONS shall require Immunization Records for all students attending the 2020-2021 school year. In adhering to Kentucky State law:

All students in grades K-8th must have two doses of the Hepatitis A vaccine. Your child may have already be in compliance with the new regulations as many health care providers and local health departments have been administering the Hepatitis A vaccine for several years.

ALL students must provide a new Immunization Record that shows he/she has received all age appropriate vaccines, in order to attend the 2020-2021 school year at CHRISTIAN ACADEMY OF CHAMPIONS.

Physical Exams:

Any new student attending the 2020-2021 school year at CHRISTIAN ACADEMY OF CHAMPIONS must obtain a vision exam and/or provide a vision examination record from an optometrist.
Person legally PROHIBITED from contact with student
Name

First Name Last Name
Name

First Name Last Name
In case of School closing or Early Dismissal, contact
Name

First Name Last Name
Phone Number

Area Code Phone Number
Name

First Name Last Name
Phone Number

Area Code Phone Number
CHRISTIAN ACADEMY OF CHAMPIONS' Financial Commitment Considerations

Christian Academy of Champions asks for a financial commitment from those who enroll for next year. Enrollment is a commitment from the parents to pay for one of year tuition.

1.         Christian Academy of Champions takes commitments very seriously. Commitments are like covenants which bind two parties together. As Christians we should honor our word just as Christ honors His word to us.

2.         Christian Academy of Champions commits to the parents to provide a full year of education for the anticipated tuition payments. The school is committed to be here for the child and plans each year of expenditures based on the enrollment numbers.

3.         Christian Academy of Champions depends on tuition payments to pay expenses. Expenses for the school include salaries and various contracts for copiers, computer maintenance, and software updates, as well as supplies, testing, and manyaditional items in the school budget. The school budget is based on the commitments of the parents to send their child (ren) to the School. Once contractual relationships are made, the school cannot undo these contracts.

4.         The enrollment commitment does guarantee that a slot will be held for the child and the school makes that commitment to the parents. If the child does not partake in the next school year, it is not a simple matter of saying that the school has plenty of time to “fill that slot”. Even if another child comes in that grade, the school still loses the anticipated tuition income for the full year for your child.

Tuition Accountability/Early Cancellation:

The parent for each child enrolled at CHRISTIAN ACADEMY OF CHAMPIONS shall accept full accountability for the child's fees & tuition. Early cancellation must be received by July 31, 2020 for new students enrolled in the 2019-2020 school year. It shall be understood by the parents that no refunds shall be repaid for any payments made by the responsible party. If cancellation occurs after July 31, 2020, the parent shall be responsible for payment of the full semester's tuition and/or any unpaid portion thereof. If a student has been expelled from CHRISTIAN ACADEMY OF CHAMPIONS, the parent shall remain responsible for the payment of the full semester's tuition and/or any unpaid portion thereof. Refunds toward any pre-paid tuition shall be considered on a case by case basis for any families who can provide proof of financial hardship or proof of a legitimate move from the area.

Delinquent Accounts:

Any account with a balance 10 days past due shall incur a $50 late fee. Any accounts past due 21-60 days shall incur a $75 late fee and a conference meeting will be scheduled between the parent and CHRISTIAN ACADEMY OF CHAMPIONS administration. Failure to meet the financial obligations by the due date may require that the student withdraw from future classes at CHRISTIAN ACADEMY OF CHAMPIONS, until an agreement can be made between the family and CHRISTIAN ACADEMY OF CHAMPIONS administration. All returned checks or non-sufficient funds shall incur a $25 penalty. Any fees incurred by CHRISTIAN ACADEMY OF CHAMPIONS to collect on a past due account shall be the responsibility of the parent that enrolled the student in CHRISTIAN ACADEMY OF CHAMPIONS. CHRISTIAN ACADEMY OF CHAMPIONS cannot continue to provide a quality education in a safe environment without the commitment from each family to meet their financial obligation.
Initials *
Student Registration fee is $850.00 per child. Late Registration (after August 1, 2020) is $1,000 and is due at registration. ***The registration fee is non-refundable and is separate from any payment plan. This fee must be paid in full and submitted with the Student Application to retain student position on class roster. This fee includes all books, testing and processing.
Initials *
I/we understand for my/our convenience in making payments, the tuition can be divided into semester or monthly payments.

I/we understand that I/we am/are responsible for the full amount of the current month's tuition even if my/our child(ren) is/are withdrawn or dismissed from CHRISTIAN ACADEMY OF CHAMPIONS. The remaining balance is due and payable at the time of withdrawal or dismissal.

I/we understand prompt payment of tuition is the foundation of the school’s operating budget. Payments are due on the first (1st) day of each month with a $30.00 late fee if payment is returned by the bank and/or payment is not received by the tenth (10th) day of each month. Thereafter, the tuition payment is delinquent. Report cards and transcripts will be held until the account is made current.

I/we also understand that Christian Academy of Champions reserves the right to deny students admission to their classes when tuition payments are delinquent.

Furthermore, I/we agree that in the event it is necessary for the school to retain an attorney in order to enforce collection of tuition and fees due under this contract, the undersigned parent(s) or guardian(s) agree to pay all costs of collection including a reasonable attorney’s fee and all court costs.
Initials *
Electronic Signatures. Each party agrees that the electronic signatures, whether digital or encrypted, of the parties included in this Agreement are intended to authenticate this writing and to have the same force and effect as manual signatures. Delivery of a copy of this Agreement or any other document contemplated hereby bearing an original or electronic signature by facsimile transmission (whether directly from one facsimile device to another by means of a dial-up connection or whether mediated by the worldwide web), by electronic mail in “portable document format” (“.pdf”) form, or by any other electronic means intended to preserve the original graphic and pictorial appearance of a document, will have the same effect as physical delivery of the paper document bearing an original or electronic signature.

I also agree to the terms of this form.
Signature *

Clear

My Products

Registeration Fee $ 500.00

Quantity

Online Classes or homeschool option $ 150.00

Please call 270-599-7535 if you have any questions. Online classes with once a week in person classes for tests and quizzes and to help with any subject needed. If needed, we can help more days than one in any 2 subjects. $150 per month for 10 months, (If meeting more than once a week with help in 3 or more subjects, it will be $250 a month). 1 or 2 subjects up to 5 days a week in person classes are included as are all field trips.

Quantity

Online classes $ 1,350.00

Online classes with once a week in person classes for tests and quizzes and to help with any subject. $1,500 per year save 10% by paying for the entire year $1,350 If needed, we can help more days than one in any 2 subjects. (If meeting more than once a week with help in 3 or more subjects, it will be an extra $100 a month for the months needed). 1 or 2 subjects up to 5 days a week in person classes are included as are all field trips.

Quantity

Total $ 0.00

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Christian Academy Of Champions Registration Form

Person legally PROHIBITED from contact with student

In case of School closing or Early Dismissal, contact