Student Enrollment & Release Form: SPROUTS

Tutoring Student Enrollment & Release Form: The MJB School of Life

Fill out the form carefully for registration
Student Name

First NameLast Name
Birth Date (Month, Day, Year)
What Grade Will Your Student Be Going To Next School Year?

1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade
Gender
Parent's or Guardian's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Emergency Contact

First NameLast Name
Phone Number

FAMILY HANDBOOK
PLEASE CLICK HERE TO DOWNLOAD OUR STUDENT/PARENT HANDBOOK.
I have downloaded the MJB School of Life Student/Parent Handbook. I have reviewed and accept all policies stated within the document.

I ACCEPT

Notice of Exemption

As a parent/legal guardian, I acknowledge and understand that the MJB School of Life is not a licensed child care facility. I further acknowledge that this program is exempt from state licensure requirements and is not required to be licensed by the Georgia Department of Early Care and Learning.
Signature

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Date

MonthDayYear
Date
Use this as a checklist to make sure you have printed and signed both the Student/Parent Acknowledgement Page and the Notice of Exemption Page in the Student/Parent Handbook.

I have printed and signed the Handbook Acknowledgement Page.I have printed and sign the Notice of Exemption Page.
Should be Empty:

Tutoring Student Enrollment & Release Form: The MJB School of Life