Achieve Academy Enrollment Contract for the 2025/2026 School Year

Achieve Academy Enrollment Contract

for the 2025/2026 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
Student Name

First NameLast Name
Birthdate

MonthDayYear
Date
Age
Gender
Shirt Size
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of last school attended
Last Grade completed
SECOND CHILD’S INFORMATION
Name

First NameLast Name
Birthdate

MonthDayYear
Date
Age
Gender
Shirt Size
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of last school attended
Last Grade completed
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 and severally liable for the tuition and 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:
1. Enrollment: Student, if accepted, will be enrolled for all of the 2025- 2026 academic year which runs from August 1st, 2025 to July 31st, 2026. Parents are obligated to make twelve monthly payments to Achieve Academy of $600 per month from August 1st, 2025 to July 31st, 2026 or ten monthly payments of $720 from August 1st, 2025 to May 31st, 2026. The Contract is valid only for the academic year stated and does not entitle Student to any future enrollment. Initial below
Initial
Please select the following payment option for the 2025/2026 academic year.

12 monthly payments of $60010 monthly payments of $720
2. Tuition Deposit and Registration Fee: Parent understands that for the School to consider Student’s application and to conditionally reserve a place for Student for the academic year stated above, Parent must submit the original executed Contract, along with a $100 Tuition Deposit, made payable to Achieve Academy. Parent understands that the Tuition Deposit is earned by the School upon Parent’s submission of the Contract and fees to the School and the School’s consideration of Student’s application. The Tuition Deposit will be applied to tuition for the academic year covered by this Contract. The Tuition Deposit is not refundable unless the School rejects, in its sole discretion, Student’s application for admission and unilaterally cancels this Contract; in such case, the School will retain $25.00 of the Tuition Deposit, refunding the remainder to Parent. The Tuition Deposit may be transferable at the discretion of the School. A registration fee of $85 is payable yearly for each student. Parent agrees to pay this fee on submission of the contract. This fee is waived if the contract is completed, signed and returned to the Principal by April 11, 2025. Initial below
Initial
3. Tuition: Tuition amounts must be paid in full, monthly, an outstanding balance cannot be applied to the following month. In cases where the tuition is not paid by the end of the month in which it is due, student shall be unable to attend or participate in school activities. Initial below
Initial
4. Tuition Obligation. Parent understands that Student is being enrolled for the entire School Year or 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 year’s tuition and fees as liquidated damages (and not a penalty) 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 or tuition, and any unpaid balance may, at the School’s election, become immediately due and payable. Initial below
Initial
5. 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
6. Summer School. Parent understands that summer school is mandatory for student attendance, unless the option of ten monthly payments has been preselected and adhered to throughout the school year. Initial below
Initial
7. Book Fee and School Supplies Fee: Parents agree to pay a once-yearly book fee and school supplies fee for each student enrolled. The book fee is $240 for students in first grade or below and $340 for students in second grade and above. The school supplies fee is $65 for each student. Both fees must be paid in full by June 16th, 2025. Initial below
Initial
8. Additional Fees and Incidentals: Parents agree to pay the School for incidental fees, which may include interest, late fees, overdue library fees, unreturned textbooks, before and after school care, and field trips. Initial below
Initial
9. 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
10. 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
11. Termination of Student’s Attendance: The School has the right to suspend or 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, or for the Parent’s failure to pay all or any part of the Parent’s financial obligations for Student’s attendance (including any amounts charged on Student’s account with the School). Initial below
Initial
12. Payment and Late Fees: Parent understands and agrees that a Late Charge of $50.00 will be added for any delinquent payment (which is defined as a payment not received within 4 days after the due date). Any further delinquent payment (which is defined as a payment not received within 8 days after the due date) will be subject to an addition late charge of $50, for a total of $100 of late fees. In the event of default (default being 30 days past due), Parent also agrees to pay all costs of collection, including collection agency fees, attorneys’ fees, court costs, and interest of 1.5% per month. Further, as to any account more than 90 days in arrears, the School reserves the right to accelerate the total unpaid balance of tuition and fees due under this Enrollment Contract. When accounts are in arrears, the account may be referred to the School’s collection agent and/or counsel for satisfaction. Initial below
Initial
13. Default of Payment: All accounts must be current before records and transcripts can be released or transferred to other schools. Student will not be allowed to continue to attend classes or participate in other School activities unless tuition and fees are paid by stated deadlines (or until Parent makes other written arrangements acceptable to the School). Initial below
Initial
14. 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
15. 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
16. 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 tuition 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
17. 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
18. 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
19. New Student Transcripts: If Student is transferring from another school, it is the Parent’s responsibility to ensure that the transferring school promptly provides the School with an official transcript. Initial below
Initial
20. Student’s Satisfactory Completion of Current School Year: This Contract is further conditioned upon the Student successfully completing the current school year in good standing, both academically and behaviorally. If, after completion of the current school year, the School determines in its sole discretion that Student has not met this requirement, the School has the right to unilaterally cancel this Contract. Initial below
Initial
21. 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
22. 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
23. 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
24. 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 full year’s tuition 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. Reimbursement for Domestic Legal Issues: Parent understands and agrees that the School’s primary purpose is to provide educational opportunities to the students within its institution. Parent also understands that it is disruptive to the School for a Parent to involve the School (or any of its employees)in domestic legal disputes between the Parents and that the School often must pay for legal fees and costs associated with such issues. Therefore, the Parent agrees to promptly reimburse the School for all expenditures incurred by the School as a result of Parent’s domestic legal disputes, including, but not limited to: Parental disagreements about Student’s education or placement; divorce proceedings; custody proceedings; and/or modifications of custody proceedings. Cost incurred may involve reasonable attorneys’fees/costs to prepare for and/or attend depositions, trials, or hearings; communication with Parent or Parent’s counsel, guardian’s ad litem or attorney’s ad litem; respond to subpoenas; draft letters or motions; and perform research. Costs include the cost of copying documents, providing records, engaging substitute teachers or temporary employees, computerized research, and travel expenses. Parent agrees to reimburse the School for such fees/costs within thirty (30) days of School billing Parent for such expenses. Any dispute between the Parents regarding which Parent may owe which portion of the bill should be resolved between the Parents so that the bills for reimbursement to the School can be paid on a timely basis. Parent’s failure to pay such fees/costs promptly will result of dismissal of the family from the School.
Initial
26. 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. Fundraising Efforts: Parents agree to participate in all fundraising efforts on behalf of Achieve Academy and Achieve Foundation.
Initial
28. Authority: Each party represents and warrants to the other (1) that it has full power to enter into and perform its obligations under this Contract; and (2) that this Contract constitutes its legal, valid, and binding obligation, enforceable in accordance with its terms. Parents in two-parent households agree that each is acting as agent for the other. Modification of this agency relationship shall be in writing and delivered to the School. No oral modifications will be recognized or accepted. Parents agree to settle any outstanding balance at 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

Powered by Jotform SignClear
Date

MonthDayYear
Date
Print Name

First NameLast Name
Signature of Parent 2 or legal guardian

Powered by Jotform SignClear
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:

Powered by Jotform SignClear
Date

MonthDayYear
Date
Name

First NameLast Name
The person signing below, represents “the School”, Achieve Academy

Powered by Jotform SignClear
Date

MonthDayYear
Date
Name

First NameLast Name
Is your application dependent on receiving Promise Scholarship funds? (Not applicable to current Achieve students)*

YesNo
Food Allergies, Intolerances & Dietary NeedsForm
Child's Name & Allergy (if applicable)
List your child's name followed by a description of their allergy, the severity of the allergy and any necessary interventions.
Food Intolerance
Child's Name & Food Intolerances (if applicable)
List your child's name followed by a description of their food intolerance, the severity of the intolerance and any necessary interventions.
Dietary Needs Questionnaire
Child's Name & Dietary Needs (if applicable)
List your child's name followed by a description of their dietary needs and a substitute if necessary.
Is your child aware of their allergy/food intolerance/dietary need?
Is there any other information you would like to share to help us meet your child’s needs?
Parent Signature

Powered by Jotform SignClear
Emergency Contact / Authorized Pick Up Person Form
Emergency Contact Information (not parent)

First NameLast Name
Relationship to student
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

Powered by Jotform SignClear
Parent Name

First NameLast Name
Date

MonthDayYear
Date

Exemption Parent Statement

Achieve Academy is an independent school that offers individualized learning plans. By incorporating Georgia Standards, Achieve provides an excellent academic foundation, as well as a curriculum and activity program that introduces and expands social and developmental skills. Achieve Academy is not a licensed early care and learning facility. Achieve Academy operates as a private school.
I, First Name Last Name , acknowledge the statement above and am aware that my child(ren) is/are attending a non-licensed facility. (A facility not licensed by Bright from the Start)
Signature

Powered by Jotform SignClear
Date

MonthDayYear
Date

Registration for Accredited Transcripts

This form is for parents who wish for their child to receive official, accredited transcripts through our partner school, Wynfield Christian Academy. These transcripts ensure that students' academic records are easily transferable between schools and colleges. While not required, this option is highly recommended for students in 1st grade and above.
Wynfield Christain Academy Enrollment Application

Renee K. Walker, CEO

143 Williamson Drive

Macon,Georgia 31210

978-563-9663

Documentation Only Online Enrollment Application (For New Students)

Thank you for your interest in Wynfield Christian Academy (WCA We look forward to getting to know you and your student. Below is a checklist of admissions information required by WCA. Instructions for digital submission and non-digital submission are on page four of this application. If you have any questions at any point during the admissions process, please contact us.

Renée K. Walker, CEO and Tracy Rhoades, Principal Packet Checklist: Place an X in each blank certifying requirements have been met before mailing.

1. Printed copy of application (not needed if emailed with digital signature)

2. Release the School Records:The form is located on homepage under WCA School Information and Homeschool Resources; click on the Request for School Records link. If homeschooled the previous year, provide a list of courses finished in the last completed grade. Include curriculum name, publisher and the final grade attained by your student. (Ex. Abeka English Grade B; Apologia Chemistry Grade B

3. Copy of student test scores attached.

4. Copy of parent/mentor's transcript, degree or diploma. Please inform if already on file.

5. Mandatory Technology fee - $35.00 non-refundable per family per year

6. Registration Fee - $100.00 non-refundable

7. Tuition payment is due by the tenth of each month, August through May, regardless of your individual school calendar. Include $5.00 late fee for any payment made after the 10th of the month. Tuition will be adjusted if enrollment is after August 31st, to insure full tuition is received prior to May 10th of the school year.

High School Students 9-12th - $300 per year or $30 per month due by July 1st.

After July 1st, - $350.00 per year or $35.00 per month.

Elementary students K-8th - $100.00 or $10.00 per month.
Student Information

Type your answers in spaces provided.
Child 1

First NameLast Name
Date of Birth

MonthDayYear
Date
Social Security Number
Address
City
State
Zip Code
County of Residence
Phone
Most Recent School Placement
School System
Child 2

First NameLast Name
Date of Birth

MonthDayYear
Date
Social Security Number
Most Recent School Placement
Last Grade Completed
School System
Parent 1 Information
Last Grade Completed
Name

First NameLast Name
Email
example@example.com
City
State
Zip Code
Work
Cell
Educational Level
Occupation
Employer
Parent 2 Information
Name

First NameLast Name
Email
example@example.com
City
State
Zip Code
Work
Cell
Educational Level
Occupation
Employer
The following questions have already been answered. Please review them to ensure your understanding.
Yes 1. The student will be mentored by either a parent with a high school diploma or by a non-parent with a Bachelor's degree.

2. Please indicate who will be the student's Mentor:
Tara Pvel
Mentor
Name:Pvel Tara N Email:tarapvel@gmail.com
Address:1602 Elberta Rd Warner Robins, GA 31093
Home
Phone:478-342-2270 Work Cell:478-342-2270
Degree: Master's in Education Mentor Signature: Tara Pvel

Yes 3. I understand that the mentor will maintain weekly grades.

Yes 4. The mentor agrees to document 24 clock hours of informational seminars on WCA Online or another approved activity by WCA.

Yes 5. The mentor and student will complete and submit all requirements, within a 30 day timeframe of all tests completed, and meet deadlines as stated in the Yearly Requirements, Academics Policies and Deadline section within the School Information Room on the WCA

Yes 6. The student will take a course final per course in the presence of a center staff member.

Yes 7. The student will have a secluded, quiet area of study. Describe area of study.

Classroom with own desk and small class size

8. List the student and family goals for your homeschool program. To improve educational outcomes for the student

Yes 9. The student will have access to research encyclopedia or CD-ROM capability.

Yes 10. I understand that a graduate of WCA must have one set of national standardized test scores per school year on file and one SAT/ACT score before high school graduation.

Yes 11. The student must have opportunities to engage in frequent group enrichment and socialization activities. In which homeschool association or co-op are you actively involved?

Yes 12. I understand that a student must complete a minimum of 120 clock hours of course activity per course, and maintain a school year of 180 days with each day being a minimum of 4.5 hours.
13. 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
Parents can submit payment either directly to Wynfield Christian Academy or provide it to us for forwarding.

Option 1: Submit Payment Directly
Mail the payment to:
Susann Short
105 Lentz Dr
Macon, GA 31220

Option 2: Submit Payment Through Us
Provide the payment to us, and we will ensure it is forwarded to Wynfield Christian Academy on your behalf.

Please make all checks and money orders to cover these costs payable to Wynfield Christian Academy.
Student's Name
Student's Grade
Disclaimer and Signature: Ga. Law requires grades to be sent to the state within a specific timeframe. (Graduating students of WCA must meet deadlines in order to prevent problems receiving an accredited diploma and/or the Hope Scholarship Monetary penalties or loss of college scholarships due to submission of late records may incur if deadlines are not met.

By signing below:

I certify I am the parent of the student named on this application.

I certify that I have read and am in agreement and compliance with all the information concerning WCA Home Study Program.

I understand and agree that if proper documentation is not submitted, WCA cannot grant credit for the program.

I understand that satisfactory enrollment in the WCA program for one year is required before prior credit can be verified by WCA.

I understand full tuition will be required regardless of whether my student completes the grade level and/or withdraws early from the program.

I understand annual standardized testing and graduation fees are non-refundable, and will be billed separately.

I have read and understood and agree to abide by all policies, requirements, and fees of Wynfield Christian Academy.

I understand this contract will be valid and legally binding through calendar years and/or grade levels as long as the student is enrolled in the WCA program. The required, written withdrawal form must be completed and submitted to staff to end the enrollment period. I understand my digital e-signature, any photocopy or facsimile of this authorization has the same effect as the original. I also understand this authorization shall remain in effect from the date of contract and for all years student is enrolled with WCA.
Parent Signature

Powered by Jotform SignClear
Date

MonthDayYear
Date
Should be Empty:

Achieve Academy Enrollment Contract

FIRST CHILD’S INFORMATION

SECOND CHILD’S INFORMATION

PARENT/GUARDIAN 1 INFORMATION

PARENT/GUARDIAN 2 INFORMATION

Food Allergies, Intolerances & Dietary NeedsForm

Food Intolerance

Dietary Needs Questionnaire

Emergency Contact / Authorized Pick Up Person Form

Exemption Parent Statement

Registration for Accredited Transcripts

Student Information

Parent 1 Information

Parent 2 Information