2024/2025 Registration Application
  • Emergency Information/Medical Release/Liability Waiver Form

    This form is necessary for any prospective student at Beavercreek Freedom Academy. Please complete this form and return it with application. The prospective student will not be fully registered without this form signed by a parent or guardian. Please fill out the requested information completely and list any additional information that may be important should an illness or injury occur.
  • Participant Information

    • Student (1) 
    • Date of Birth*
       - -
    • Student (2) 
    • Date of Birth
       - -
    • Student (3) 
    • Date of Birth
       - -
    • Family Information 
    • Format: (000) 000-0000.
    • Format: (000) 000-0000.
    • Format: (000) 000-0000.
    • Format: (000) 000-0000.
    • Format: (000) 000-0000.
    • Emergency Contacts

      Please include two non-parents
    • Emergency Contact (1) 
    • Format: (000) 000-0000.
    • Format: (000) 000-0000.
    • Emergency Contact (2) 
    • Format: (000) 000-0000.
    • Format: (000) 000-0000.
    • Emergency Contact (3) 
    • Format: (000) 000-0000.
    • Format: (000) 000-0000.
    • Emergency Contact (4) 
    • Format: (000) 000-0000.
    • Consent 
    • Medical Treatment Consent

      In the event that neither I nor the additional designated emergency contacts can be reached, I authorize and consent for my child to receive any and all health care services available from and deemed necessary by the staff of Beavercreek Freedom Academy and their associated provider agencies/treating physicians.
    • I consent to the following checked items, if deemed immediately necessary to safeguard my child's health:
    • Date*
       - -
  • Minor Photo Release Form

  • Dear Parents/Guardians,

    Beavercreek Freedom Academy will be taking photographs of events and activities held during the schol year. Some of these photographs may include your child/children. Therefore, we are requesting your permission to use these photographs for any legal use, including but not limited to: publicity, copyright purposes, illustration, advertising and web content. This permission includes both print and online sites. 

  • Please indicate below if you choose to allow Beavercreek Freedom Academy to use photographs with your child or children in this manner:*
  • Date*
     - -
  • Format: (000) 000-0000.
    • Student (1) 
    • Student (2) 
    • Student (3) 
    •  
    •  
    • Should be Empty: