Kingdom Academy 2024-2025 Enrichment Enrollment
Parent Information
Full Name
*
First Name
Last Name
Phone Number
*
E-mail
example@example.com
Parents 2 (secondary contact)
*
First Name
Last Name
Parent 2 Phone Number
*
Parent 2 Email
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact
*
First Name
Last Name
Emergency Contact Phone Number
*
Pick-up Authorization: Include first name, last name, and phone numbers of all adults authorized to pick up your students.
*
Home Church
*
Student Information
Student 1: Full Name
*
First Name
Last Name
Student 1: Grade Level for 2024-2025 School Year
*
Please Select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Student 1: Date of Birth
*
-
Month
-
Day
Year
Date
Student 1: Gender
*
Male
Female
Student 1: Does your child have any FOOD allergies or dietary restrictions?
*
Yes
No
If yes, please list here.
Student 1: Other health / behavioral information. Please include any other info that would be important for our staff to know. All non-food allergies may be listed in this section as well.
Student 1: Class / friend requests
Enrolling a 2nd student?
*
Yes
No
Student 2: Full Name
*
First Name
Last Name
Student 2: Grade Level for 2024-2025 School Year
*
Please Select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Student 2: Date of Birth
*
-
Month
-
Day
Year
Date
Student 2: Gender
*
Male
Female
Student 2: Does your child have any FOOD allergies or dietary restrictions?
*
Yes
No
If yes, please list here.
Student 2: Other health / behavioral information. Please include any other info that would be important for our staff to know. All non-food allergies may be listed in this section as well.
Student 2: Class / friend requests
Enrolling a 3rd student?
*
Yes
No
Student 3: Full Name
*
First Name
Last Name
Student 3: Grade Level for 2024-2025 School Year
*
Please Select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Student 3: Date of Birth
*
-
Month
-
Day
Year
Date
Student 3: Gender
*
Male
Female
Student 3: Does your child have any FOOD allergies or dietary restrictions?
*
Yes
No
If yes, please list here.
Student 3: Other health / behavioral information. Please include any other info that would be important for our staff to know. All non-food allergies may be listed in this section as well.
Student 3: Class / friend requests
Enrolling a 4th student?
*
Yes
No
Student 4: Full Name
*
First Name
Last Name
Student 4: Grade Level for 2024-2025 School Year
*
Please Select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Student 4: Date of Birth
*
-
Month
-
Day
Year
Date
Student 4: Gender
*
Male
Female
Student 4: Does your child have any FOOD allergies or dietary restrictions?
*
Yes
No
If yes, please list here.
Student 4: Other health / behavioral information. Please include any other info that would be important for our staff to know. All non-food allergies may be listed in this section as well.
Student 4: Class / friend requests
Enrolling a 5th student?
*
Yes
No
Student 5: Full Name
*
First Name
Last Name
Student 5: Grade Level for 2024-2025 School Year
*
Please Select
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Student 5: Date of Birth
*
-
Month
-
Day
Year
Date
Student 5: Gender
*
Male
Female
Student 5: Does your child have any FOOD allergies or dietary restrictions?
*
Yes
No
If yes, please list here.
Student 5 Other health / behavioral information. Please include any other info that would be important for our staff to know. All non-food allergies may be listed in this section as well.
Student 5 Class / friend requests
Additional Information
Please list any additional comments or requests pertaining to your enrollment if needed.
Have any of the students listed above ever been dismissed or suspended from any program or school?*
Yes
No
Please explain the circumstances regarding the suspension or dismissal.
*
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Kingdom Academy Parental Consent Form: 2024 - 2025 School Year
A copy of the handbook will also be emailed to you upon confirmation of your enrollment. All families will need to agree to our Handbook to confirm enrollment.
This consent form is hereby voluntarily signed as parent or legal guardian for the child(ren) listed as part of the application for enrollment to Kingdom Academy. The undersigned parent or guardian agrees and consents to the terms herein. Please read through each of the following statements and check each box to agree.
1. Tuition & Withdrawal Policy - I have reviewed Kingdom's tuition and fee structure and understand my obligation to submit payments on time. The enrollment fee is due upon registration to secure my child's spot, and this fee may be nonrefundable. If tuition is not paid by the 5th of each month, a $10 daily late fee will be added to my account. I understand that Kingdom reserves the right to remove my child from the program if fees are not submitted.
*
I Agree
2. Liability Waiver - By signing this consent form, you are granting permission for your child to participate in the activities and programs offered by Kingdom Academy KC LLC. This agreement not only allows your son or daughter to be part of the enriching educational and recreational opportunities provided by the academy, but it also releases Kingdom Academy KC LLC and its affiliated organizations from any liability in the event that your child sustains an injury during the course of the school year.This liability waiver is an important safeguard for the academy, shielding them from potential legal action in the unfortunate circumstance of an accident or incident occurring. As the parent or guardian, you are acknowledging that participation in the academy's activities carries inherent risks, but you are willingly accepting those risks by giving your consent. In exchange, your child gets to enjoy all the benefits that Kingdom Academy KC LLC has to offer, from academic instruction to extracurricular programming.By signing this agreement, you are making a commitment not to sue or initiate any civil proceedings against Kingdom Academy KC LLC or its partners. This protects the organization from costly and time-consuming litigation, allowing them to focus their resources on providing an exceptional educational experience for your child and all the students enrolled. Overall, this consent form represents a mutual understanding and acceptance of responsibilities between you as the parent and the academy, ensuring a safe, productive, and enriching school year for your son or daughter.
*
I Agree
3. Photo Release - By granting Kingdom Academy KC LLC permission to utilize photographs, videos, or other marketing materials that feature your child, you are allowing the organization to incorporate these visual assets into their promotional and advertising efforts. This gives Kingdom Academy KC LLC the flexibility to showcase your child's participation and involvement in their programs, camps, or events across a variety of marketing channels. Whether it's highlighting your child's engagement in classroom activities, their enthusiasm during sports or recreational pursuits, or their achievements and accomplishments, these visuals can be a powerful tool for Kingdom Academy KC LLC to attract prospective students and families, generate interest in their offerings, and build a positive, compelling brand identity. In doing so, your child may appear in brochures, on the organization's website, across their social media platforms, in email newsletters, or in other promotional materials distributed throughout the community. This not only provides valuable exposure for Kingdom Academy KC LLC, but it also celebrates your child's experiences and can instill a sense of pride in their participation. By granting this permission, you are supporting the academy's marketing initiatives while also allowing your child's journey to be shared in an uplifting manner that showcases the enriching opportunities available through Kingdom Academy KC LLC.
*
I Agree
By Signing below you are agreeing to all items above.
*
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Enrollment Fee
Your students enrollment fee will be included in your September tuition payment. Payment options will be sent out towards the end of August.
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