Homeschool Program Contract for the 2024/2025 School Year

Homeschool Program Contract

for the 2024/2025 School Year
This contract is made between Achieve Academy (referred to as “The School”), 1602 Elberta Rd., Warner Robins, GA 31093 and the parents/guardians of the student(s) named below (referred to as “The Parents”).
FIRST CHILD’S INFORMATION
Name

First NameLast Name
Birthdate

MonthDayYear
Date
Age
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current grade
Learning Delivery Method (Virtual school, individualized curriculum, etc.)
Which learning style most applies to the student?

Auditory ex. Lectures, audiotapes, etc.Visual ex. Videos, texts, etc.Kinesthetic/Tactile ex. Hands-on, experiments, manipulatives, etc.Other
SECOND CHILD’S INFORMATION
Name

First NameLast Name
Birthdate

MonthDayYear
Date
Age
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Current grade
Learning Delivery Method (Virtual school, individualized curriculum, etc.)
Which learning style most applies to the student?

Auditory ex. Lectures, audiotapes, etc.Visual ex. Videos, texts, etc.Kinesthetic/Tactile ex. Hands-on, experiments, manipulatives, etc.Other
PARENT/GUARDIAN 1 INFORMATION
Name

First NameLast Name
Home Number
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
PARENT/GUARDIAN 2 INFORMATION
Name

First NameLast Name
Home Number
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Work Phone
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
All persons signing this Contract are jointly liable for the fees set forth herein. Parent’s signature and/or initials on this Contract evidence Parent’s understanding and agreement to the terms of this Contract, as follows:
Please select the following option for the 2024/2025 academic year.

Pop Ins - $40 for any chosen Wednesday in the academic year.Monthly - $35 each Wednesday for a month (see chart below for pricing)Per Semester - $30 each Wednesday in a semester (see chart below for pricing)

Attendance Fees

Pop-Ins: Parent understands that for the School to fulfill the contract and to conditionally reserve a place for Student(s) each day, Parent must submit a payment of $40 to Achieve Academy before 8am on the Wednesday. Parent agrees to pay this fee on by the day of the service.

Montlhy: Parents understands that for the School to fulfill the contract and to conditionally reserve a place for Student(s) each month, Parent must submit payment for each month on the 1st of each month to Achieve Academy. Parent agrees to pay the following fees (as applicable) on the 1st of each month:

Month	August	September	October	November	December
Price	$105	$140	$140	$105	$105

Month	January	February	March	April	May	June
Price	$140	$140	$140	$105	$70	$140

Per Semster: Parents understands that for the School to fulfill the contract and to conditionally reserve a place for Student(s) each semester, Parent must submit payment on the 1st of each three months in the semster to Achieve Academy. Parent agrees to pay the following fees (as applicable) on the 1st of each month:

For semester 1 (Aug - Dec):

Month	August	September	October
Price	$198	$198	$198

For semester 2 (Jan - Jun):

Month	January	February	March
Price	$245	$245	$245

1. Enrollment: If accepted, students will be enrolled for the specified period. Parents are obligated to make the selected payments to Achieve Academy during the 2024/2025 academic year. The Contract is valid only for the time period stated and does not entitle Student to any future enrollment. Initial below
Initial
2. Attendance Fees: Fees must be paid in full, daily or monthly, an outstanding balance cannot be applied to the following month. In cases where the fee is not paid on the first of the month in which it is due, Student shall be unable to attend or participate in school activities. Initial below
Initial
3. Fee Obligation. Parent understands that Student is being enrolled for the entire period covered by this Contract. Parent further understands that the overhead expenses of the School do not diminish with the departure of some students during the course of the school year and agrees that it is impossible for the School to determine at the time of Parent’s execution of this Enrollment Contract the damage and loss to the School that would occur due to the later cancellation/withdrawal of some of the students who have enrolled. Therefore, once this Contract has been submitted to the School, Parent becomes liable for the entire fees attached to the chosen plan (Pop-Ins, Monthly, or Per semester) even if the Student is withdrawn, absent, or is involuntarily separated from School, unless the School rejects, in its sole discretion, Student’s application and unilaterally terminates this Contract. If Student is withdrawn, absent, or involuntarily separated, for any reason, including without limitation, change of residence, health, withdrawal, or expulsion, there will be no refund or reduction of fees, and any unpaid balance may, at the School’s election, become immediately due and payable. Initial below
Initial
4. Force majeure: Notwithstanding anything to the contrary contained herein, neither party shall be liable for any delays or failures in performance resulting from acts beyond its reasonable control including, without limitation, acts of God, acts of war or terrorism, shortage of supply, breakdowns or malfunctions, interruptions or malfunction of computer facilities, or loss of data due to power failures or mechanical difficulties with information storage or retrieval systems, labor difficulties or civil unrest. Notwithstanding the foregoing, in the event of such an occurrence, each party agrees to make a good faith effort to perform its obligations hereunder. In the event of the reoccurrence of the threat of Covid-19, or other virus/disease/pandemic, the School reserves the right to offer its services through other means, such as distance learning and home student packets. Initial below
Initial
5. School Rules: Student’s enrollment at the School is subject to the general statements, rules, regulations, conditions, and financial terms contained in the School’s Parent and Student Handbook and other published documents, which may be amended from time to time. Parent acknowledges that Parent and Student must abide by such School rules and guidelines. Initial below
Initial
6. Support: Student’s enrollment at the School is subject to Parent support of the standards of the School in its philosophy, methods, objectives, and policies, including moral, academic, behavioral, dress, conduct, and disciplinary standards; to assume the responsibility for parental monitoring of Student’s education, being an encourager, and keeping in regular contact with Student’s teachers; and to attend mandatory meetings called by the School. Parent also agrees to support, to the best of Parent’s ability, the School’s entire program through time, attendance at parent meetings, and participation in various School activities. Initial below
Initial
7. Termination of Student’s Attendance: The School has the right to terminate the attendance of any student for reasons set forth in the Parent and Student Handbook (or other published document), for reasons that the School Administration considers detrimental to the School community, student, or to other students of the School. Initial below
Initial
7b. Termination of Student's Attendance: Parent understands and agrees that the School will terminate the attendance of any student if fees are not paid according to the selected payment schedule.
Initial
13. Photos and Images: The Parent agrees to allow the Student’s name, photograph, voice, image, and information to be used by the School for use in the School’s publications, promotion materials, social networks, and website, without compensation and without prior notice. Parent also allows Student to be interviewed by the media on campus or at school-related events. Parent releases and holds the School harmless from any liability stemming from the use of the Student’s name, photograph, voice, image, or information. Initial below
Initial
14. School Directory: Parent authorizes the School to place family information, including name(s), home address(es), email address(es), and telephone numbers of Parent, Student, and other children in attendance at the School, in a directory of students to be available to administration, teachers and substitutes. Parent acknowledges that this directory and the information therein is not to be used for commercial use and is not to be distributed to any other person or agency. Initial below
Initial
15. School/Family Cooperation: A positive and constructive relationship between the School and Family Member (defined as Parent, Student, or other person associated with Student) is essential to the School’s educational purpose and responsibilities to its students. If any Family Member engages in behavior, communications, or interactions on or off campus, that is disruptive, intimidating, overly aggressive, or reflects a loss of confidence in or disagreement with the School’s policies, methods of instruction or discipline, or otherwise interferes with the School’s safety procedures, responsibilities, or accomplishment of its educational purpose or program, the School reserves the right to dismiss the Family or Family Member from the community. The School may also place restrictions on a Family Member’s involvement or activity at School for other reasons that the School deems appropriate. Any determination under this Paragraph shall be in the School’s sole discretion. There will be no refund of fees where such dismissal occurs and any unpaid balance is payable in full according to the terms of this Contract. The School also reserves the right to withdraw an offer of enrollment or re-enrollment at any time and to void an executed Enrollment Contract. Initial below
Initial
16. Medical Authorization: If, in the opinion of a properly licensed and practicing physician, Student needs medical or surgical services which require Parent’s pre-authorization or consent, Parent hereby authorizes, appoints, and empowers the School to act as Parent and furnish such consent on Parent’s behalf. Parent confirms that it is Parent’s desire that Student be furnished with such medical or surgical services as soon as reasonably possible after the need arises. Parent hereby releases and holds the School harmless from any liability which might arise from the giving of such consent. Parent agrees to reimburse the School for any medical expenditures made on Student’s behalf. Initial below
Initial
17. Consent to Onsite Medical Care, Including Referrals for Student Counseling: The Parent hereby authorizes the School to supply medical care as needed for Student (including administration of allergy medications, EpiPens, etc. according to the Student’s prescription from a licensed practitioner) or other minor medical care or emergency as determined to be appropriate by the School Staff. Parent hereby releases and holds the School harmless from any liability which might arise from the provision of such medical care. Initial below
Initial
20. Release of Student Records: Parent consents and holds the School harmless for the release of Student’s records and information upon request by an educational institution or law enforcement agency. Parent also releases and holds the School harmless from any liability stemming from the use, disclosure, or release of Student’s records or information. Initial below
Initial
21. Promotional Materials/Statements: The School continually strives to ensure the accuracy of all written materials, including, but not limited to, promotional information, catalogs, brochures, handbooks, and advertising. In an effort to do so, however, information included in the materials (including class sizes, student-to-teacher ratios, School accreditation, teacher qualification, specialization, and length of service, etc.) may change as programs grow and as staff changes. Prior to relying on any written materials in making your decision to enroll Student in the School, please verify the accuracy of information with the Principal. Please also understand that even if the information was accurate at the time that you enrolled the Student, the information may change prior to commencement of classes or during attendance at the School. Please also note that only the Principal (or his/her designee) has the authority to make commitments regarding the nature of the program, specific arrangements for Student, or other changes from the School’s regular curriculum. Initial below
Initial
22. Governing Law: This Contract and the rights and obligations of the parties shall be governed by and construed in accordance with the laws of the State of Georgia without regard to principles of conflicts of law.
Initial
23. Understanding of Terms: Please read this Contract carefully. By signing below, Parent acknowledges that Parent understands the terms of this Contract, Parent’s obligation to pay the fees even if the Student is withdrawn or dismissed, the Parent’s option to terminate, and all other obligations set forth herein. If Parent has questions about the terms, Parent is encouraged to seek advice of counsel or to seek clarification from the Principal.
Initial
25. Parent’s Commitment to Truthfulness in the Admissions and Enrollment Process: The School is relying on the completeness and truthfulness of the information provided by the Parent in the admissions and enrollment process. If the School finds out after the Student has been admitted and enrolled that the Parent was not truthful in the admissions and enrollment process on any issue that the School, in its sole discretion, finds to be important, the School has the absolute right to terminate this Contract. There will be no refund of tuition where such termination occurs and any unpaid balance is payable in full according to the terms of this Contract.
Initial
27. Authority: Each party represents and warrants to the other (1) that it has full power to enterinto and perform its obligations under this Contract; and (2) that this Contract constitutes its legal, valid, andbinding obligation, enforceable in accordance with its terms. Parents in two-parent households agree that eachis acting as agent for the other. Modification of this agency relationship shall be in writing and delivered to theSchool. No oral modifications will be recognized or accepted. Parents agree to settle any outstanding balanceat other independent, private, or public schools prior to enrollment in the School.
Initial
28. Entire Agreement: This Agreement sets forth the entire understanding of the parties here to with respect to the subject matter hereof and merges and supersedes all prior and contemporaneous oral understandings between the parties. There have been no representations or warranties made by anyparty other than the representations and warranties contained herein.
Initial
Signature of Parent 1 or legal guardian

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Date

MonthDayYear
Date
Print Name

First NameLast Name
Signature of Parent 2 or legal guardian

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Date

MonthDayYear
Date
Print Name

First NameLast Name
The person signing below, although not a Parent or Legal Guardian, is agreeing to be responsible for all financial obligations set forth above:

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Date

MonthDayYear
Date
Print Name

First NameLast Name
Food Allergies & Intolerances Form
Child 1

First NameLast Name
Child 1
First Name
Food Allergy

DairySoyEggsPeanutsTreenutsFishShellfishSesameCornWheat (do not check this for celiac disease or gluten sensitivity, only wheat allergy)Other (list below)No known food allergies
If other please list
Child 2
First Name
Food Allergy

DairySoyEggsPeanutsTreenutsFishShellfishSesameCornWheat (do not check this for celiac disease or gluten sensitivity, only wheat allergy)Other (list below)No known food allergies
If other please list
Food Intolerance
Child Name
First Name
Check all applicable

Gluten (celiac disease or non-celiac gluten sensitivity, includes wheat, barley, oats, rye)LactoseFructoseSulfitesHistaminesNitritesFructansTyramineGalactansFava beansMSGSalicylatesPolyolsCitric acidNightshadesNo known food toleranceOther
Please list any other Special Diet needs or restrictions (i.e., Diabetes, IBS, other):
Dietary Needs Questionnaire
Child Name
First Name
1. What are the preferred food substitutions, if any? (soy butter for peanut butter, gluten free breads, soy milk etc):
2. What types of contact will cause a reaction?

AirborneTrace CrossContactActual ingestion
Please explain above where necessary
3. Does your child understand the food allergy and what needs to be done to manage it?
yes/no any additional information
4. Is there any other information you would like to share to help us meet your child’s needs?
Parent Signature

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Emergency Contact / Authorized Pick Up Person Form
Child 1

First NameLast Name
Child 2

First NameLast Name
Emergency Contact Information (not parent)

First NameLast Name
Relationship to student if not parent
Authorized Pick Up Person(s) 1

First NameLast Name
Phone Number
Please enter a valid phone number.
Vehicle model, make and color
Authorized Pick Up Person(s) 2

First NameLast Name
Phone Number
Please enter a valid phone number.
Vehicle model, make and color
Authorized Pick Up Person(s) 3

First NameLast Name
Phone Number
Please enter a valid phone number.
Vehicle model, make and color
Parent signature

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Parent Name

First NameLast Name
Date

MonthDayYear
Date

Homeschool Program Contract

FIRST CHILD’S INFORMATION

SECOND CHILD’S INFORMATION

PARENT/GUARDIAN 1 INFORMATION

PARENT/GUARDIAN 2 INFORMATION

Food Allergies & Intolerances Form

Food Intolerance

Dietary Needs Questionnaire

Emergency Contact / Authorized Pick Up Person Form

Exemption Parent Statement