SCA Full Enrollment Form

- Student # 1 Name
  
  First NameLast Name
- Student #1 Date of Birth
- GirlBoy
- Pre-K FourKindergarten1st2nd3rd4th5th6th7th8th
- Student #1 Last School Attended
- Student #1 School District last attended
- Student #1 Previous School Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Is your child/children currently or in the past been on a 504 Plan or IEP? If so, please provided more information. (Student #1)
- Please Upload Your Student's Previous Records, if you have those files. If not, contact your child's previous school to obtain them and provide to SCA. Student #1
  
  Browse Files
  
  Cancelof
- Student Request Form
- Student #1 Medical Information
- List allergies (student #1)
- Does your child have any medical conditions? (student #1)
- List any medications your child is currently taking. (Student #1)
- Does your child have any physical or medical condition that impacts his/her ability to participate in classroom and group learning environments? If yes, describe. (Student #1)
- Does your child have any mental or emotional condition that impacts his/her ability to participate in classroom and group learning environments? If yes, describe. (Student #1)
- Student First Name Last Name. I/we First Name Last Name do hereby give consent for the school to administer necessary minor medical attention such as Benadryl and basic medical treatment. In the case of an medical emergency, I give consent for the school to call the appropriate emergency response.
- Parent/legal guardian Signature
- Student Information
- Student #2 Name
  
  First NameLast Name
- Student #2 Date of Birth
- GirlBoy
- Student #2 Ethnicity (optional, for state records)
- Pre-K FourKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade
- Student #2 School District last attended
- Student #2 Previous School Name
- Student #2 Previous School Phone no.
  
  Area CodePhone Number
- Student #2 Previous School Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Is your child/children currently or in the past been on a 504 Plan or IEP? If so, please provided more information. (Student #2)
- Please Upload Your Student's Previous Records, if you have those files; if not, contact your student's previous to obtain them. Student #2
  
  Browse Files
  
  Cancelof
- Student Request Form
- Student #2 Medical Information
- List allergies (student #2)
- Does your child have any medical conditions? (Student #2)
- List any medications your child is currently taking. Student #2)
- Student First Name Last Name. I/we First Name Last Name do hereby consent to my child's medical care and the administration determined by a physician to be necessary for the welfare of my/our child while said child is under the care of Spicewood Christian Academy.
- Parent/Legal Guardian Signature
- Student Information
- Student #3 Name
  
  First NameLast Name
- Student #3 Date of Birth
- GirlBoy
- Student #3 Ethnicity (optional, for state records)
- Pre-K fourKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade
- Student #3 School District last attended
- Student #3 Last School Attended
- Student #3 Previous School Phone no.
  
  Area CodePhone Number
- Student #2 Previous School Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Is your child/children currently or in the past been on a 504 Plan or IEP? If so, please provided more information. (Student #3)
- Please Upload Your Student's Previous Records, if you have them. If not, please contact your student's previous school to obtain them. Student #3
  
  Browse Files
  
  Cancelof
- Student Request Form
- Student #3 Medical Information
- List allergies (student #3)
- Does your child have any medical conditions? (Student #2)
- Student First Name Last Name. I/we First Name Last Name do hereby consent to my child's medical care and the administration determined by a physician to be necessary for the welfare of my/our child while said child is under the care of Spicewood Christian Academy.
- Parent/Legal Guardian Signature
- Student Information
- Student #4 Name
  
  First NameLast Name
- Student #4 Date of Birth
- Student #4 Ethnicity (optional, for state records)
- Pre-K FourKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade
- Student #4 Last School Attended
- Student #$ School District last attended
- Student #4 Previous School Phone no.
  
  Area CodePhone Number
- Student #4 Previous School Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- Is your child/children currently or in the past been on a 504 Plan or IEP? If so, please provided more information. (Student #4)
- Please Upload Your Student's Previous Records. Student #4
  
  Browse Files
  
  Cancelof
- Student Request Form
- Student #4 Medical Information
- List allergies (student #4)
- Does your child have any medical conditions? (Student #4)
- Student First Name Last Name. I/we First Name Last Name do hereby consent to my child's medical care and the administration determined by a physician to be necessary for the welfare of my/our child while said child is under the care of Spicewood Christian Academy.
- Parent/Legal Guardian Signature

- Why would you like your child to attend Spicewood Christian Academy?
- Family Home Church
- RegularlyOccasionallyI do not attend Church

Family Emergency Information

Please complete all fields in this section.
Family Emergency Contact Name
Emergency Contact Relationship to Student
Emergency Contact Phone Number

Area CodePhone Number
Family Doctor
Family Doctor Phone Number

Area CodePhone Number
This person Does NOT have permission to pick up my child/ren.

First NameLast Name
Phone Number

Area CodePhone Number

Permissions, Notices and Waivers

Please read and answer appropriately.
OFF CAMPUS Learning Opportunities

During the course of the school year, SCA will organize off-campus learning experiences. These may include state parks, historical farms, government buildings, and science museums. SCA will organize these as family opportunities. Parents must accompany their student(s) or make arrangements for another SCA parent to do so. SCA will not transport students. SCA will not assume responsibility for supervising students at the location. SCA's only role is to organize, publicize, and facilitate the off-campus learning opportunity.
Photo Agreement

I grant permission for my child to be included in photographs which SCA staff publish. I understand that students' names are never included with any photographs, and that photographs with potentially identifying information for any SCA student (e.g., name tag, award certificate) are not used, so as to avoid any identification of student's names. I understand that SCA staff will use student photographs on social media or in print materials for the purpose of promotional and fundraising materials, information materials, and for inclusion in the SCA Yearbook.
I declineI agree
Signature
Financial Commitment

Please read and confirm your understanding of the financial commitment to SCA.
Tuition and Registration Fee Commitment

I understand the Student Registration Fee is non-refundable.

I understand the tuition commitment is for a full semester, once the student has participated in classes. SCA makes a commitment to teachers based upon tuition commitments. Prior to the start of classes, a student may be withdrawn and tuition is not due. But once a student has attended SCA and participated in classes, the tuition commitment is for an entire semester.
I decline, and understand that my child's enrollment may not be approved.I agree
Signature
SCA Textbook Damage

I understand if my child damages, defaces or loses SCA Textbooks, Hymnals, or school equipment I will be responsible for damages or replacement.

There will be a $100 book deposit per middle school student. Please write an individual check for $100 (not included in tuition/registration fee) to Spicewood Christian Academy that will be held on file. Checks will be voided at the end of the year if not needed.
I declineI agree
GENERAL WAIVER:

I, the undersigned legal guardian of the student(s) named below, HEREBY ASSUME ALL OF THE RISKS OF MY STUDENT PARTICIPATING IN ANY/ALL ACTIVITIES ASSOCIATED WITH ENROLLMENT AT SPICEWOOD CHRISTIAN ACADEMY (“SCA”), including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of SCA, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault. I certify that there are no health-related reasons or problems which preclude my child/children's participation in SCA class activities. I acknowledge that this Accident Waiver and Release of Liability Form will be used by SCA staff, volunteers, and organizers of any SCA activity in which my child/children may participate. In consideration of my child’s enrollment in SCA, I hereby take action for my child/children, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, THE FOLLOWING ENTITIES OR PERSONS: Spicewood Christian Academy (SCA) and/or their directors, officers, employees, volunteers, representatives, and agents, and the activity holders, sponsors, and volunteers; (B) INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of my student's participation in this activity, whether caused by the negligence of release or otherwise. I acknowledge that SCA and their directors, officers, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf.

MEDICAL RELEASE:

I hereby consent to my student receiving medical treatment which may be deemed advisable and necessary, in the event of injury, accident, and/or illness that occurs while on SCA campus. By signing this form, I hereby authorize SCA staff to consent to any medical care and treatment for the student(s) named below that is recommended by a licensed healthcare provider to whom the student(s) is presented for treatment. In order to ensure that the student(s) named below receives prompt medical care and treatment when necessary, I hereby release any licensed health care provider who provides medical care to the student(s) named below from any and all liability relating to the medical care that the provider deems essential to the health of the student(s) named below.

The Accident Waiver and Release of Liability Form shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

I CERTIFY THAT I HAVE READ THIS DOCUMENT AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY AND A CONTRACT AND I SIGN IT OF MY OWN FREE WILL.

In the case of this form being completed and submitted online, such submission is a digital signature of and agreement to this waiver and release.
Signature
Signature
Should be Empty:

Spicewood Christian Academy

Student #1 Medical Information

Student #2 Medical Information

Student #3 Medical Information

Student #4 Medical Information

Family Emergency Information

Permissions, Notices and Waivers

Financial Commitment