KACHEA Co-Op Family Registration 2022-2023

KACHEA CO-OP FAMILY REGISTRATION

2023-2024
Parent's names*

First NameLast Name
Parent's names

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary phone*
Other phone(s)
Church you attend
Pastor's name
PRE-SCHOOL/ELEMENTARY/MIDDLE SCHOOL STUDENTS:
Child #1
Age (as of 09/01/23)
Grade (23/24)
Any allergies, learning disabilities, etc.?
Child #2
Age (as of 09/01/23)
Grade (23/24)
Any allergies, learning disabilities, etc.?
Child #3
Age (as of 09/01/23)
Grade (23/24)
Any allergies, learning disabilities, etc.?
Child #4
Age (as of 09/01/23)
Grade (23/24)
Child #5
Any allergies, learning disabilities, etc.?
Age (as of 09/01/23)
Grade (23/24)
Any allergies, learning disabilities, etc.?
HIGH SCHOOL STUDENTS:
Student #1
Age (as of 09/01/23)
Grade (23/24)
Class Selections:
1st hour
2nd hour
3rd hour
Student #2
Age (as of 09/01/23)
Grade (23/24)
Class Selections:
1st hour
2nd hour
3rd hour
Student #3
Age (as of 09/01/23)
Grade (23/24)
Class Selections:
1st hour
2nd hour
3rd hour
Please list any crime which your student(s) who are participating in KACHEA Co-Op have been convicted of or pled guilty to, or any current legal issues below. If this does not apply to your student(s), please simply write NONE.*
Signed Signature*

Clear
Date*

MonthDayYear
Date
Registration fee: $22 per child, ages 0-12th grade.

Background Check fee: $15 per parent/adult that will be teaching at (participating in) Co-Op. Any parent/guardian that may bring students (at any time throughout the school year) must plan to remain at and participate in Co-Op that day and must have a completed background check. The only exception is High School students that bring themselves to Co-Op (see below). This is to remain in compliance with our legal and insurance requirements.

Additional fees for High School:

- Science courses: $12 per student, per year, per class they are attending.

- Student-only (no parent attending or participating in Co-Op): $80 per student per year ($40 per semester), per class they are attending.

Fee Maximums: There is a $110 maximum per family registration fee. If you have more than 5 students, please contact Jennifer Davies to submit the information for each student above 5. There will be no additional registration fees. ***Please note: This cap does not includes the background fee and any High School science fees or student-only fees (parent not participating in Co-Op).

Registration deadline: August 1, 2023.

Membership required: In order to participate in KACHEA Co-Op, you must also belong to the KACHEA organization. If you do not already belong for the 2023-2024 school year, please complete that registration as well. (Register at kachea.com or follow the registration button on kacheacoop.com. Be sure to choose the properly dated forms.)

Payment Options: You will receive a PayPal invoice, based on your total fees, to your email address for your records. You may choose to pay...

- Online via PayPal by completing the invoice. Be sure to use an email address you can access and check often.

- Via check by mailing a check to Jennifer Davies, 1725 Carters Valley Rd, Surgoinsville, TN 37873. Please make checks out to KACHEA Co-op. Your automatic PayPal invoice will be marked as paid once the check is received and clears the bank. (If you choose to pay this way, you do not need to include the additional $2 to help cover PayPal fees.)

Trouble registering or have questions? Please contact the Co-Op Director, Jennifer Davies at mrsjdavies4@gmail.com or 616-291-8303.

Completed registration: Please be aware that registrations for Co-Op are NOT considered complete until all forms have been received, all fees have been paid, and all background checks are completed.
Please list (in the order of your preference) your three choices of where you would like to help.
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Student RegistrationThe registration fee is $22 per student, with a family cap of $110. (If you have more than 5 students, please contact Jennifer Davies to submit the information for each student above 5. There will be no additional registration fees.)
$22.00 Quantity
Item subtotal:$0.00



Parent Background CheckEach adult who will be participating in any way with Co-Op must have a background check run. Select the quantity based on the number of adults.
$15.00 Quantity



High School Science Class fee (per student, per class)This fee offsets the cost of supplies and materials for high school science classes. Select this option once per student, per high school science class. (Only if you have a student taking a science course.)
$12.00 Quantity
Item subtotal:$0.00



Late registration feeA late fee of $15 is assessed for any registrations submitted after July 15, 2023.
$15.00



High School student-only fee (no parent participation)$80 ($40 per semester), per class, per student
$80.00 Quantity
Item subtotal:$0.00



Subtotal

$0.00

Shipping

$0.00

Total

$0.00
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