Clone of YHSS Course Registration Form

Young Homeschool Scholar Society Academy *Application*

The Young Homeschool Scholar Society (Y.H.S.S.) is an academic program designed for high-achieving homeschool students in grades 3-6 (8 years old - 11 years old), focused on fostering academic excellence. Y.H.S.S. offers a variety of enriching opportunities.
The Medical & Engineering Institute provides an engaging, hands-on learning experience for homeschool students in 3rd to 6th grades. Led by experienced professionals and experts in medicine and engineering, this program offers specialized instruction, interactive workshops, and collaborative projects. Students meet twice a month during the Fall and Spring semesters, with sessions held on the first and third Tuesday of each month. This program is designed to challenge and inspire students by exploring real-world applications in these fields, helping them develop critical thinking skills and gain valuable insights into the future of medicine and engineering.

Students will also have the opportunity to participate in field trips, which will include, but are not limited to, visits to prestigious institutions such as the Johnson STEM Center, Georgia Tech, and Morehouse School of Medicine. These excursions will further enhance their learning experience by providing exposure to cutting-edge technologies and professionals working in these exciting industries. Perfect for students passionate about medicine and engineering, this program will help them expand their knowledge and pursue their interests in these dynamic fields. Payment is required within 48 hours of acceptance.
Cost per semester - $250 and this includes 2 uniforms
Student Name*

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent Name*
Parent E-mail*
example@example.com
Mobile Number*
Phone Number
Emergency Contact*
example@example.com
Emergency Contact Number
Current Grade Level:*
2 Uniforms will be issued to each scholar the semester. Uniforms are to be returned at the semester.*

Polo Dress SPolo Dress MPolo Dress LPolo Dress XLPolo Dress XXLBoys Polo Shirt SBoys Polo Shirt MBoys Polo Shirt LBoys Polo Shirt XLBoys Polo Shirt XXL
What is pants size for boys? (Parents responsible for khaki pants and cardigan but if you are interested in used please complete.)
How long have you been homeschooling (must have proof of letter of intent)*
Homeschool Program/ Curriculum Overview (Briefly describe your homeschooling background):
In what areas do you consider your scholar academically advanced?
Has your student worked on any science or engineering projects at home or in your homeschool group? (If so, describe the project(s) briefly. If not, please explain your interests in these subjects.)
If your student had to choose a project related to medicine or engineering, what would it be and why? (For example, building a model of a heart, a robot or designing a building’s structure.)
The program includes monthly sessions and occasional field trips that are mainly on Tuesdays (some cases special events may fall on a Wednesday or Thursday). Can you confirm whether your child will be able to attend sessions? Please explain any factors that might affect their ability to attend.
Collaboration is a key aspect of this program. Has your student ever worked with a team? If not, are they open and willing to doing so?
Does your child have any health concerns or allergies that we should be aware of for participation in field trips or hands-on activities? (Please describe, including any required accommodations.)
Is there any other information about your child that we should know to ensure their successful participation in the program? (This can include learning preferences, behavioral support, etc.)
What would you like your student to take away from this experience?
Photo/Video Release - I hereby grant Young Homeschool Scholars Society permission to use my and my child(ren)'s likeness in photography and/or videos in any and all of its publications, including but not limited to all printed and digital publications. I understand and agree that any photographs and/ or videos using my child(ren)'s likeness will become property of Y.H.S.S. and will not be returned. I acknowledge that since my participation is voluntary, I will receive no financial compensation.*

I agreeI do not agree
Parent Commitment AgreementAs part of the Young Homeschool Scholar Academy, it is essential for parents to remain engaged and responsive to ensure a successful academic experience for your child. Please confirm your commitment to this by agreeing to the following:By signing this form, I commit to being responsive and timely in communicating with the Young Homeschool Scholar Academy team regarding important updates, requests, and feedback throughout the academic year.*

I agreeI do not agree
Liability Waiver - The undersigned, on his or her own behalf, and/or behalf of the Participant(s) identified below, acknowledges, appreciates and agrees to the following conditions:I represent that I am the parent or legal guardian of the Participant(s) named below, or I have obtained permission from the parent/legal guardian of the participant(s) named below to execute this agreement on their behalf. I agree that the participant(s) named below and I shall comply with all stated and customary terms, posted safety signs, rules, and verbal instructions as conditions for participation in Y.H.S.S events. In addition, if I observe any hazard during our participation, I will bring it to the attention of the other parents immediately.I am aware that there are inherent risks associated with participation in programs and activities andI, on behalf of myself and the participant(s) named below, knowingly and freely assumed all such risks, both known and unknown, including those that may arise out of the negligence of other participants, and I, for myself and the participant(s) named below, and our respective heirs, assigns, administrators, personal representatives and, next of kin, herby release and hold harmless Young Homeschool Scholar Society, their affiliates, officers, members, agents, employees, other participants, and sponsoring agencies from and against any and all claims, injuries, liabilities or damages arising out of or related to our participation in Young Homeschool Scholar Society's program and activities.*

I agree
Are you interested in volunteering for the program (background check is required)
Additional Comments/Any additional information you would like to share about your student.
Onboarding Zoom Call (If Selected):

• If your child is selected for the program, we will schedule an onboarding Zoom call for all accepted students and their parents/guardians.

• Purpose: The call will provide important program details, answer any questions, and give families a chance to meet other participants and instructors.

• Instructions: After the application review, selected applicants will receive a link to schedule their onboarding Zoom call.
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Young Homeschool Scholar Society Academy *Application*

Young Homeschool Scholar Society Academy Application