Parent Survey: Class of 2025

From Name

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Email Address*

example@example.com

Parent/Guardian Mobile Number*

Please enter a valid phone number.

Add 2nd Parent/Guardian*

YesNo

Parent/Guardian 2 Name*

First NameLast Name

Parent/Guardian 2 Email Address*

example@example.com

Parent/Guardian 2 Mobile Number*

Please enter a valid phone number.

Student Name*

First NameLast Name

Please list any allergies. If none, type none.*

Does your child require an epi pen for allergic reactions?*

YesNo

Does your child have any activity restrictions? If none, type none.*

Please sign up for as many areas as you'd like to volunteer! If you are already a chair or on a committee for a certain area, please do not sign up to volunteer for that area. NOTE: It is not guaranteed that all volunteers will be needed, and you may not hear from someone until it gets closer to the event date. Thank you.

Kick-Off Party: Sunday 8/4/24

Senior Wall Setup: Early August, Date TBD

Last First Day Breakfast: Thursday 8/7/24 @ 7:30 a.m.

Senior Treat Day #1: Thursday 9/17/24

Senior Treat Day #2: Wednesday 11/19/24

Senior Christmas Treat: Thursday 12/13/24

Senior Treat Day #3: Thursday 2/5/25

Senior Wall Decor Install: Spring Break, Date TBD

Senior Treat Day #4: Thursday 4/1/25

Senior Week: 4/22, 4/23, 4/24 (2025)

Senior Picnic & Field Day: Friday 4/25/25

Grad Night: Thursday 5/15/25

Photography Volunteer

Social Media Photography Volunteer

Music/Playlist Volunteer

Dad Handy/Manual Labor Volunteers

Please provide the name and phone number of the person providing manual labor.*

Other Volunteer Options

I am not available to volunteer at events, but please contact me if I can help in another way.The event I wanted to help with is full.

Please note which event you'd like to help with below.*

Location/Venue Details

Special Talent Details

Donations

Thank you for your financial donation! Please provide the amount you'd like to donate.*

Is your family interested in learning more about the senior trip?*

YesNo

If yes, how many people from your family plan to go?*

Our child, a student at Jackson Academy (JA), desires to participate in the Senior Year Kick-Off Party, Senior Breakfast, Senior Treat Days, Senior Service Project Days, Senior Week, and Grad Night activities for the 2024-2025 school year. We understand that occasionally injuries occur in this sport or activity and that JA provides supplemental insurance coverage but will not assume any risk or responsibility for any injury that occurs while participating in the activity.

We agree that our child may participate in the sport or activity; that we will be fully responsible for any and all doctor, hospital, and related medical expenses related to any injuries or damages sustained while participating in said sport or activity or travel in connection therewith; that we waive and release JA from any claim of any kind we or our child might have relating to any injuries or damages sustained while participating in said sport or activity or travel in connection therewith; and that we indemnify and hold harmless JA from any such claim that might be made.

We acknowledge that the Senior Trip that will be held following graduation is a non-JA event and that JA has no association with the trip in any way from a legal or financial standpoint.

Waiver Acceptance*

I accept.I do not accept.

Parent Survey

Parent Information

Student Information

Allergies/Restrictions

Volunteer Opportunities

Locations/Venues

Special Talents & Contributions

Senior Year Donations

Senior Trip Interest

Waiver