K-12 Re-Enrollment Form

K-12 Application for Admission
Application Date:*

MonthDayYear
Date
Age:*
What grade will your child be attending?*
School Year:*
Student Name:*

First NameMiddle NameLast Name
Preferred Name (or Nickname):
Date of Birth:*

MonthDayYear
Date
Gender:*

MaleFemale
Race:*
Social Security Number:*
Street Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mailing Address*

Mailing Address

Mailing Address Line 2

CityState / Province

Postal / Zip Code
County
Home Phone Number
Please enter a valid phone number.
FAMILY INFORMATION: *Note: The contact information given below should only pertain to the party who is responsible for the student. MACA's procedures are to deal only with the legal guardian(s) of each student.
Applicant lives with (check all that apply):*

FatherStepfatherFather has custodyParents are separateMotherStepmotherMother has custodyParents are divorcedJoint custodyOther
Please Print Parents' / Guardians' Name and Full Address Below:
Father/Guardian/Stepfather:

First NameLast Name
Mother/Guardian/Stepmother:

First NameLast Name
Relationship to Student:
Relationship to Student:
Residing County
Residing County
Email Address
Email Address
Cell Phone Number
Please enter a valid phone number.
Cell Phone Number
Please enter a valid phone number.
Student's Church Name:*
Church Phone Number
Please enter a valid phone number.
Pastor Name:*

My Products

Application FeeMACA Application Fee is a one time fee per family. You can drop off $75.00 to our office or pay online. Online payments include a 3% fee.

$77.25

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please return your enrollment form along with the registration fee as soon as possible to secure a place for your student.

Mountain Area Christian Academy

Mountain Area Christian Academy School Board

The primary responsibility of the Board is to oversee the general operation of the school and to ensure that the school meets its spiritual, legal, and academic obligations.

Chairman:        Cherie Wasit

Members:         Brenda Crawford, Phillip Kight, Darrin and Nikki Sparks, Brooke Campbell, Matthew & Tiffany Ritter

Cooperation

In order to ensure the effective operation of Mountain Area Christian Academy, it is necessary to have the full cooperation, support, and backing of every parent and guardian in the matter of school policies, rules, and regulations. The school asks parents and guardians to become familiar with all policies as outlined in the Student Handbook (available online at www.macalions.org) and fully support those policies.

Tuition

Mountain Area Christian Academy is a nonprofit organization and is dependent on tuition, fees, fundraising and gifts for its support. Payment dates will be strictly enforced. All accounts must be brought current within 10 days of the statement due day or a late fee of $50 will be applied. Accounts past due thirty (30) days will result in financial suspension. These fees include (but are not limited to) tuition, lunch, aftercare, etc.

Agreement

By signing this application, I agree to partner with Mountain Area Christian Academy in its efforts to train my child in a way that is both pleasing to the Lord and in accordance with the Holy Scriptures. I agree to the programs and policies as outlined in the Student Handbook.

By signing this form, I give permission to be called and/or texted using automatic dialing equipment at the numbers listed on this application and I certify that I am the woner of the phone numbers listed.
Signature of Father or Legal Guardian

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Date

MonthDayYear
Date
Signature of Mother or Legal Guardian

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Date

MonthDayYear
Date
Signature of Student (Required for students 4th grade and above)

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Date

MonthDayYear
Date
Notice of Nondiscriminatory Policy as to Students: Mountain Area Christian Academy admits students of any race, color, and national or ethnic origin to all the rights, privileges, programs, and activities generally accorded or made available to students at the school. It does not discriminate on the basis of race, color, national and ethnic origin in administration of its educational policies, admissions policies, scholarship and loan programs, and athletic and other school-administered programs.
Mountain Area Christian Academy

Medical Care and Emergency Contact Information

School Year 2024/2025

*This is in addition to the parents/ legal guardians if a situation may arise where the parent/ legal guardian cannot be reached.
Emergency Contact 1:*

First NameLast Name
Emergency Contact 2:*

First NameLast Name
Relationship to Student:*
Relationship to Student:*
Residing County*
Residing County*
Email Address
Email Address
Cell Phone Number*
Please enter a valid phone number.
Cell Phone Number*
Please enter a valid phone number.
Child's Physician:*
Physician Phone Number*
Please enter a valid phone number.
Physician's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Known Allergies of Child (medicine, food, etc.)
Describe past serious illnesses or hospitalizations (include dates):
Medicines taken by child:
Date of last Tetanus Shot:

MonthDayYear
Date
Describe all physical conditions or illnesses that could affect the child's participation in the programs or the proper medical treatment (diabetes, epilepsy, poor blood clotting, etc.):
Health Insurance
Company:
Policy Number:
Mountain Area Christian Academy

Medical Care and Emergency Contact Information

Continued
Permission to Dispense Medication During School Hours: (Please mark all that apply)
Medication Name: Tylenol (Acetaminophen)
Dosage:
Check all that apply:

LiquidTablet
Medication Name: Ibuprofen
Dosage:
Check all that apply:

LiquidTablet
Medication Name: Triple Antibiotic Ointment (Neosporin)

Dosage: Apply to affected area 1-3 times a day
Medication Name: Anti-Itch Cream (Diphenhydramine Hydrochloride USP, 2%)

Dosage: Apply to affected area 1-3 times a day
I hereby give permission for my child (named above) to receive medication during school hours. I understand that the school personnel take no responsibility for the administration of the medication. I hereby release Mountain Area Christian Academy and their agents and employees from any and all liabilities that may result from my child taking over-the-counter medications.
Signature of Parent/ Guardian*

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Date*

MonthDayYear
Date
Emergency Medical Treatment Consent
I hereby give Mountain Area Christian Academy permission to provide first aid care for my child blanks. In the event I cannot be reached, I hereby authorize Mountain Area Christian Academy to transport my child to the emergency room of the hospital listed below, and I hereby grant my consent for the hospital and its medical staff to provide my child with medical treatment. I agree to accept financial responsibility for all medical expenses incurred.
Signature*

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Date*

MonthDayYear
Date
Mountain Area Christian Academy

Child Release Form
The following people are authorized to pick up my child:
Name:

First NameLast Name
Relationship:
Name:

First NameLast Name
Relationship:
Name:

First NameLast Name
Relationship:
The following people are NOT authorized to pick up my child:*If one of the persons listed is a parent, then MACA MUST have court action papers on file in the office.
Name:

First NameLast Name
Relationship:
Name:

First NameLast Name
Relationship:
Name:

First NameLast Name
Relationship:
Signature*

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Date*

MonthDayYear
Date
Mountain Area Christian Academy

Q & A
How did you hear about MACA?*
Why do you wish to enroll your child in MACA?*
In transferring from another school, how would you describe your student's grades?*

SuperiorAbove AverageAverageBelow Average
What method of discipline have you found to be effective?*
Has your child ever been sent to the office for discipline problems in school? If yes, explain.*
Has your child ever been expelled from school? If yes, explain.*
Has your child ever undergone an educational evaluation administered by a clinical psychologist, psychiatrist, or counselor?*

YesNo
Has your child ever been prescribed attentions-enhancing medication?*

YesNo
If yes, is your child currently taking such medication?

YesNo
Medication Name:
Dosage / Frequency:
Please use another sheet of paper to give us any other information that might help us in meeting your child's particular needs.
Mountain Area Christian Academy

FINANCIAL OBLIGATIONS

Please check that you understand and agree to the following financial obligations.
I understand that this contract cannot be considered complete without thenon-refundable application fee ($75.00 per family).Registration fees are due upon acceptance to MACA and are non-refundable. This fee covers rental for the use of supplies, curriculum, insurance and testing while enrolled at MACA. Parents/ legal guardians must provide some supplies that will be determined by the teacher; a list will be provided. If a parent withdrawals their child, consumable supplies and curriculum previously issued to the student will be forfeited.Payment of any balance (including, but not limited to tuition, lunch charges, aftercare, late fees, extracurricular activities, etc.) is due on the first of each month. Account balances must be paid on time whether a student attends regularly or not. MACA does not accept postdated checks for any reason. Parents/ legal guardians are responsible for the payment of the account. MACA will not bill third parties.MACA recognizes that difficulties arise from time to time which may hinder prompt payments. A 10-day grace period is provided. After the 10th of the month, a $50.00 late fee will be assessed. Adjustments are not made under any circumstances. Should a parent/legal guardian’s pay period not coincide with MACA billing dates; the parent/ legal guardian will need to make arrangements so that the payment can be made according to the stated schedule. Addresses and telephone numbers must be current in the MACA office. Failure on the parent/ legal guardian’s part to promptly notify the office of an address change does not relieve him/her of the responsibility of the financial obligations outlined in this agreement.A delinquent payment notice is mailed only in the event the account is past due. Any account that becomes past due by 30 days will result in the immediate financial suspension of the student. A student may not come to class if the account is not paid as stated. Should the student be present on the suspension day, the parent/ legal guardian will be contacted that day and asked to pick up the student and keep him/her at home until the account is made current. The student may return to MACA when the account is made current.Any delinquent account balance (which may include amounts due for withdrawn students) will affect all MACA students in that family regarding financial suspension, withdrawal, etc. Should the account become 60 days past due, the student is automatically withdrawn from the roll. The total balance of the account is due at that time. All school records are held until the account has a zero balance.I understand that in addition to tuition, various fees are due periodically during a student’s enrollment at MACA.I understand and agree that no report card, transcript, or student file will be released to me or to another school if I am delinquent in tuition payment or have any debt to the school.MACA reserves the right to refuse any application or dismiss any student, at any time, for any reason. Neither this contract nor payment of fees is considered binding upon MACA.Credits posted to the account may not be applied to any non-billed items such as field trips, pictures, club fees, or any other item paid for at MACA that is not listed above. Credit posted to one families account may not be applied to another family's account.I understand that information regarding refunds and other miscellaneous financial obligations are clearly outlined in the Parent/ Student Handbook handed out once my student is accepted.I understand that new students are accepted on a probationary period of nine weeks. At the end of nine weeks the student’s performance and behavior will be evaluated. MACA reserves the right to dismiss any student who does not meet the requirements at that time.
To the best of my knowledge, the information contained in this application is true and accurate. The applicant desires to be a part of Mountain Area Christian Academy. I have carefully read the accompanying Statement of Faith and will support MACA’s inclusion of its perspective in all areas of school life. I have read the accompanying Statement of Policies (Student Handbook), Financial Contract, Code of Conduct, Uniform Dress Code,and other MACA policies. I agree to support the school in carrying out its program and policies as outlined therein. I authorize and give full consent to Mountain Area Christian Academy to publish and copyright all photographs in which my child appears as a student in any and all programs and promotional materials of the Mountain Area Christian Academy.
Signature*

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Date
Relationship to Student
Mountain Area Christian Academy

PHILOSOPHY

We believe the Bible is the standard of all truth and knowledge and therefore, are committed to teaching all subjects with God’s Word as the focal point. We believe it is our God given responsibility to teach our students traditional education fundamentals and life skills that will prepare our graduates to develop goals, make decisions, and live a life that is centered on Christ and glorifying God.

We believe that parents are the ultimate authority over their children and therefore, they are accountable to God for the child’s spiritual and more welfare.

Mountain Area Christian Academy acknowledges the trust placed in us by our parents and hold in high regard the authority of the home and church to teach those distinctive doctrines held in esteem by a family’s own local church and denomination.

STATEMENT OF FAITH

We believe the Bible to be the inspired, the only infallible and authoritative Word of God. (“All scripture is given by inspiration of God, and is profitable for doctrine, for reproof, for correction, for instruction in righteousness.” - II Timothy 3:16)

We believe there is one God, eternally existent in three persons: Father, Son, and Holy Spirit. (“For there are three that bear record in heaven, the Father, the Word, and the Holy Ghost: and these three are one.” – I John 5:7)

We believe in the deity of our Lord, His virgin birth, His sinless life, His miracles, His atoning death through His shed blood, His bodily resurrection, His ascension to the right hand of the Father, and His personal return in power and glory. (“Which also said, Ye men of Galilee, why stand ye gazing up into heaven? this same Jesus, which is taken up from you into heaven, shall so come in like manner as ye have seen him go into heaven.” Acts 1:11; see also John 10:33, Matt. 1:23, Heb. 4:15, John 2:11, I Cor. 15:3, John 11:25, Mark 16:19)

We believe that salvation can be neither deserved nor earned, but is the free gift of God given to those who accept it by faith. (“For by grace are ye saved through faith; and that not of yourselves: it is the gift of God: Not of works, lest any man should boast. For we are his workmanship, created in Christ Jesus unto good works, which

God hath before ordained that we should walk in them.” - Eph. 2:8-10; see also John 3:16, John 5:24, Rom. 5:8-9, Titus 3:5)

We believe in the resurrection of both the saved and the lost--they that are saved unto the resurrection of life and they that are lost unto the resurrection of damnation.

(“Marvel not at this: for the hour is coming, in which all that are in the graves shall hear his voice, And shall come forth; they that have done good, unto the resurrection of life; and they that have done evil, unto the resurrection of damnation.“ - John 5:28-29)

We believe in the spiritual unity of believers in our Lord Jesus Christ. (“There is one body, and one Spirit, even as ye are called in one hope of your calling; One Lord, one faith, one baptism, One God and Father of all, who is above all, and through all, and in you all. “ - Eph. 4:4-6)

We believe in the present ministry of the Holy Spirit by indwelling the Christian, enabling Him to live a Godly life. (“For whom he did foreknow, he also did predestinate to be conformed to the image of his Son, that he might be the firstborn among many brethren.” - Romans 8:29)

We believe marriage is a committed relationship exclusively between one man and one woman (Gen. 2:18-24; Matt. 19:4-6).

We believe God immutably created male and female as two distinct, complementary genders that reflect the image of God. Men and women are equal in worth and dignity, but have some distinctive God-ordained roles to fulfill. Sexual identity as male and female is determined genetically with corresponding body parts. It is linked inextricably to gender distinctions (Gen. 1:27; Eph. 5:22-33; Titus 2:4).

We believe sexual activity with another person must take place within the boundaries of marriage. (Gen. 2:24-25; Matt. 15:18-20; Rom. 13:13; I Cor. 5:1-13; 6:9-10; 13, 18; 7:1-5).

We believe that all human life is sacred because it is created by God in His image.

Human life is of inestimable worth in all its dimensions, including pre-born babies, the aged, the physically or mentally challenged, and every other stage or condition from conception through natural death. We are therefore called to defend, protect, and value all human life. (Ps 139).

We believe that in order to preserve the function and integrity of MACA that all employees and members of its community must subscribe to the Statement of Faith.
Please describe your personal relationship with Jesus Christ:
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K-12 Application for Admission