Summer 2025 Registration Form (Returning Students Only)

Academic Accommodation Needs

If your student has an IEP, 504 plan, or Neuropsych report, it is requested that we receive this information to ensure that we can best meet the needs of each individual student. Please select whether your student has any of the following (if not already shared with Headlands):

	Yes	No or N/A
IEP
504 Plan
Neuropsych Report
Additional Documentation

Please upload any additional documentation you'd like to provide so that we can best meet your student's needs.

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Please provide any additional information about your student’s specific learning strengths and preferred learning modalities to help us provide the best learning environment for your student:

Acknowledgements
Handbook Acknowledgement

Parent Acknowledgement

I have reviewed the current Parent & Student Handbook for Headlands Preparatory School and I agree to abide by the rules outlined therein.
Parent Name*
Parent Signature*

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Policies & Fees Acknowledgement

I have reviewed the 2025 Summer Policies & Fees document for Headlands Preparatory School and I agree to abide by the policies outlined therein.
Parent Signature*

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Transcript Release

I hereby authorize Headlands Preparatory School to release my/my child’s transcripts to designated schools or institutions upon my written request. I have read and agree to abide by Headlands Preparatory School’s Transcript Policy. Permission to release transcripts is for the 2025-26 school year.
- We require two business days for processing transcripts.
- There is no fee for requesting a transcript. Enrollment fees cover the costs of issuing official transcripts.
- We require parents to approve their student’s transcript (in person or by email) before we mail it.
- For college applications, parents must provide stamped, addressed envelopes, as well as a list of institutions to which the envelopes are addressed.
- Official transcripts are mailed directly from Headlands Preparatory School to middle or high schools.
- Questions regarding transcripts can be sent to admin@headlandsprep.com.
Parent Signature*

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Student Signature (if over 18)

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Vacation and Absences

All student absences are billed at the full session rate. We are not able to make courses inactive to accommodate vacations. If a family chooses to schedule a vacation when a student is actively enrolled in a course, students are welcome to attend classes remotely. We encourage families to take pre-planned vacations either before the summer start date or after their student completes any Summer courses.

To notify us that a student will be absent for any reason, parents are required to email the student’s teacher(s) and the campus administration (admin@headlandsprep.com) prior to the start of a scheduled class.

Students may not report their own absences. Email only (not a phone call) from a parent is required. To find a teacher’s email address, please log in to the online HPS Portal. Contact the administration at: admin@headlandsprep.com.

I understand and agree to the Vacations and Absences Policy.
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Honor Code

Headlands Preparatory School is devoted to individualized learning, academic mastery, personal growth, and community engagement. We view integrity as the foundation for all learning and practice. As such, we hold responsibility, intention, and reflection-- in our personal development, academic work, and interpersonal interactions-- as essential to fulfilling our mission of empowering all students.

All students, parents, faculty, and staff are committed to fostering a safe and supportive environment in which we will, individually and collectively, demonstrate consideration, respect, and reflection throughout school life. As self-directed learners, students will act with intention and integrity, and seek necessary support systems. We make this promise in order to empower all members of this community to develop themselves and the school as a whole.
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Transportation Acknowledgement

Stopping to drop off or pick up a student in the school parking lot is strictly prohibited; all student drop offs or pick ups must be off campus. Parent or student parking in the school parking lot is also strictly prohibited; permitted, metered, and free parking are all available within two blocks of campus.
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Payment Information

Your student will only be scheduled after we have received both the completed registration form and your application deposit.
- To make a payment by ACH, please use the following link: HPS ONLINE PAYMENT PORTAL.
- To make a payment by VISA, please call the school at 415-944-2254
How did you submit payment?*

I called in to make a VISA payment.I used the Online Payment Portal to make an ACH/e-check payment.
The last four digits of the transaction number are:*

Authorization for Release of Information
I/We, parent/cargiver name(s)* , give permission for the Head of School and Director(s) of Headlands Preparatory School to exchange information regarding student name* with the following persons and/or agencies:
Name, Address, Phone/Fax/Email
Email
example@example.com
I hereby release the above persons and/or agencies from any and all legal liability, which may result from the communication of the information referred to above.
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Relationship to Student*
Signature

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Relationship to Student

Emergency Documents

Please complete the required Student Emergency Form and upload the completed form below.
Student Emergency Form Upload*

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Emergency Evacuation Waiver
In the event of an evacuation, select ‘Yes’ if your child can leave campus independently or select ‘No’ if they are only allowed to leave campus with an authorized adult.*

Yes, in the event of an evacuation, my child has permission to leave campus independentlyNo, in the event of an evacuation, my child is only authorized to leave with the following individuals:

Please list persons allowed to sign student out of school along with relationship and phone number.*

	Name	Relationship to student	Phone Number
1.
2.
3.
4.

Off-Campus Permission
Occasionally teachers will take students off campus during class time for a class activity, demonstration, learning experience, etc. These off-campus excursions do not last longer than scheduled class time in order to ensure students are on campus for their next class, break, pick up, etc.*

I hereby authorize my student’s Headlands Preparatory School teacher to take my student off campus.I do not authorize my student’s Headlands Preparatory School teacher to take my student off campus.
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Should be Empty:

	July 28 - August 1	August 4 - August 8	August 11-August 14 (prorated tuition for short week)
STEAM Explorations
College Essay Writing Workshop
Sports Talk and PE

2025 SUMMER Registration Form