Creative Options Course Selection Form

Course Selection for Mighty Roots Academy: Creative Options Program

Student Name *

First Name Last Name

Date of Birth *

Date

Parent/Guardian Name *

First Name Last Name

Phone Number *

What type of enrollment?

Returning family New family

Please rank your 1st and 2nd choice foreach course in each block in which the student meets the age requirement. If a student's first choice has reached maximum enrollment, they will be placed in their 2nd choice as long as it is available. Parents will be sent a copy of the student's schedule to accept and verify course placement.

-Ages refer to the student's age as of August 1, 2022.

-Full course descriptions are found on a separate page.

-Enrollment: $200; Tuition: $1350

9:35 - 10:35 Course Block 1 *

	Forest School (CONTINUED; please select the same preferences for this below) Ages: 5-7	Musical Theater Ages: 7-15	Robotic Club Jr. $25 materials fee Ages: 6-9	Studio Art Ages: 7-11	Farm to Table Ages: 11-15
1st Preference
2nd Preference

10:35 - 11:35 Course Block 2 *

	Forest School (CONTINUED; please select the same preference for this as selected above) Ages: 5-7	Musical Theater (CONTINUED; please select the same preference for this as selected above) Ages: 7-15	Farm to Table Ages: 6-10	Learning Games Ages: 7-15	Studio Art Ages: 11-15
1st Preference
2nd Preference

11:35 - 12:35 Course Block 3 *

	Forest School (CONTINUED; please select the same preferences for this as selected above) Ages: 5-7	Lunch and Discovery Play Ages: 7-15
1st Preference
2nd Preference

12:35 - 1:35 Course Block 4 *

	Storybook Journeys Ages: 5-7	Set Design Ages: 10-15	Explorer's Club (CONTINUED; please select the same preferences for this below) Ages: 7-10	Young Performers Ages: 5-9	Mad Scientist Ages: 6-10	Outdoor Skills Ages: 9-15
1st Preference
2nd Preference

1:35 - 2:35 Course Block 5 *

	Nature Art Ages: 5-8	Dance Ages: 6-15	Explorer's Club (CONTINUED; please select the same preferences for this as selected abolve) Ages: 7-10	Gardening Ages: 6-11	Robotic Club Sr $25 materials fee Ages: 9-15	Woodworking $20 materials fee Ages: 11-15
1st Preference
2nd Preference

Applying for a Service Discount (Please complete Service Application for a $150 discount by participating in at least 10 service hours) *

Yes No

We plan to pay tuition *

In Full on July 10th. or Monthly (July 10th - April 10th) Includes $10 monthly convenience fee per family