DCA Enrollment Packet Logo

  • DCA Enrollment Packet

  • In order to complete the enrollment process, we will need the following forms and/or documents for each student:

    • Admission Application
    • Family Commitment
    • Financial Commitment
    • Release of Claims
    • Attendance Policy
    • Media Release Form
    • Student Release Authorization Form
    • HIPAA Form
    • Medical Information Form
    • Consent for Medication Dispensing
    • Emergency Contact Form

    Upload Documents

    • Recent Student Report Card
    • Current Immunization Record and/or Waiver
    • Birth Certificate

    The below documents can be obtained at the office or on our website.  You may also request them via email:

    • Pastor’s Letter of Recommendation
    • Student Records Request

  • Admission Application

  • This application is for students who desire to enroll in Destiny Christian Academy for the * academic year. The student is not accepted until a completed Enrollment package is received and approved, and registration is paid in full. (See Financial Agreement for details)

    • Applicant Home Life Infomation 
    • Spiritual Information 

  • Parental/Guardian Application Statement

  • Family Commitment

  • Please read and sign that all parents/guardians are in agreement with the below commitments:

    • I/We understand that the school program is an integral part of child training of which I am expected to support.
    • I/We hereby commit to assume my scriptural responsibility for financial support of the school.
    • I/We understand my child is expected to take part in school activities, including P.E. and sponsored trips away from the school, and I absolve the school from liability to me or my child because of injury to my child at properly supervised school activities.
    • I/We agree to uphold and support the high academic standards of the school by providing a place at home for my child to study and by encouraging my child in the completion of any homework or assignment.
    • I/We have read and understand the absence and tardy policies and will make sure to have my child to school regularly and on time.
    • I/We appreciate the standards of the school and will not tolerate profanity, obscenity in word or action, dishonor to the Godhead or Word of God, or disrespect to any DCA student/staff/volunteer.
    • I/We understand that the school reserves the right, after a parental conference, to dismiss any child who fails to comply with established regulations and discipline, or whose parents do not assume their responsibilities to the school.
    • I/We have read the parent handbook and agree to abide by all policies set forth.
    • I/We understand and agree to the terms stated on this application.
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  • Financial Commitment

  • Please read and sign that all financially responsible parents/guardians are in agreement with the below commitments:

    ESA Funded/ACE Scholarship

    • I/We understand that Education Savings Account (ESA) aka Steamboat Legacy Act monies are available per enrolled student for the current school year. I/We must apply to the State of Wyoming to access these funds. In the event I/we choose not to apply I/we will be subject the below financial responsibilities.
    • I/We shall adhere to the ESA rules and guidelines.


    Self-funded

    • I/We realize that in order to meet the financial obligations of the school, it is necessary that I keep my child enrolled for the full school term, and if circumstances beyond my control force me to withdraw my children, I agree to give 30 day’s written notice to Destiny Christian Academy, and to pay tuition in full.
    • I/We realize that Destiny Christian Academy is a non-profit organization.  I understand that if my bill is not paid by the 15th of each month, there will be a late fee assessed of $35.00, per month by the end of the month. If not paid by the end of the month, I understand that my child will not be allowed to return to DCA until such time I am able to make the payment in full.
    • I/We understand that all registration and curriculum fees are non-refundable.
    • I/We understand that there is a $25.00 service charge plus accessed bank fees on all returned or resubmitted checks and if two checks are returned or resubmitted within the school year, I will be required to make all future payments by way of cash, money order, or cashier’s check. 
    • I/We understand that payments are to be handled through the office or school administrator and not through the classroom supervisor.
      • Payments may be made:
        • By mail: Destiny Christian Academy, 215 E. 8th Street, Cheyenne, WY  82007
        • Payment Portal
    • I/We understand that records and/or report cards will not be issued or released until total accounts have been paid in full.

  • I/We *   apply for the Seamboat Legacy ESA funding.

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  • Release of Claims

  • This release of claims agreement is made and entered into on this * day of  *, Destiny Christian Acadamy (DCA) and Parent(s)/Guardian(s) of {studentFull}, your child, in the City of Cheyenne, Laramie County, in the State Of Wyoming, in allowing my child/ward to participate in all school activities of DCA for the * academic year. I do hereby release DCA, its agents, employees, members, and administrators for all personal injuries known or unknown which {studentFull} has or may incur by participating in the activities of the school. Should legal action be brought in contradiction of this release, I agree to reimburse the parties against whom it is brought for all reasonable attorney's fees and court costs. If I reach a point of disagreement on an issue of a non-criminal nature with DCA, and/or its legal corporate entity, in keeping with I Corinthians 6:1, "If any of you has a dispute with another, do you dare to take it before the ungodly for judgment instead of before the Lord’s people?", I agree to submit to a board of conciliation and the members and officials of the school rather than taking the dispute to a civil court. I agree that the procedure to be followed, including costs involved, would be that which the Christian Legal Society has established.

    I have read the release, understand its terms, and execute it voluntarily and with full knowledge of its significance. 

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  • Attendance Policy

    1. Every student is expected to attend PUNCTUALLY and REGULARLY. If a student is absent or tardy, the parent should call into the office by 9:00 am to inform the school of the absence and reason. If the parent does not call, the absence or tardy will be recorded as unexcused.
    2. No student will be permitted to leave the school at any time before the regular hour of dismissal except by written permission of the parent.
    3. Students must have a note from parents to leave school with anyone other than regular driver.
    4. Students that are absent 3 or more consecutive days due to illness will require a doctor’s note for the student to be allowed to return to school.
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  • Media Release Form

  • Destiny Christian Academy’s website and social media pages can/will include multimedia content in the form of multimedia of the staff, volunteers, students, and parents taken throughout the year of school related activities and events. Because the primary audience of our website would be better served by posting media content of these activities and events, we have set the following Web Privacy Policy guidelines.

    • Elementary: Only group multimedia will be published. Single child multimedia will ONLY be used with special consent. Also, students will not be identified, only the activity, and if appropriate, location.
    • Middle School: Only group multimedia will be published. Single child multimedia will ONLY be used with special consent. The student’s first name, as well as their class or event may identified in the picture. Example: John, Miller Farms Field Trip
    • High School: Individual and group multimedia will be published. The student(s) may be identified as listed above.

    No inappropriate or questionable content will be posted. The school administrator will preview the website or social media page before it is posted for public viewing. Student’s personal information will never be posted. i.e.

    • Phone numbers, E-mail addresses, home address, last name, age, year

    At the parent(s) request, we will make the following accommodations:

    • Withhold the student's name in High School or Middle School.
    • Withhold individual pictures of High School students.
    • Do not publish any pictures of the student.

    We welcome your input regarding these guidelines. Please let us know if you have any questions concerning our policy.

    I, *  ,  hereby   *   media release of {studentFull}, to promote Destiny Christian Academy in a Godly manner, as stated above. Please see below for any accommodations I have requested.

    Accommodation requests:

       
       

    *   Pick a Date*   

  • Student Release Authorization Form

  • I, *, do hereby authorize Destiny Christian Academy for the * academic year to release my child, {studentFull}, to the following individual(s):

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  • HIPAA (Health Insurance Portability and Accountability Act) Release Form

  • I, *, of {studentFull} for the * school year, give Destiny Christian Academy’s office staff permission to discuss anything that will benefit my child with the DCA staff. Parent/Guardian will be notified before any discussion. Any discussion between the DCA office staff and staff is confidential. 


    *    Pick a Date*   

  • Medical Information Form

  • Do you immunize?      *
    If no, you will have to complete the Medical or Religious Waiver Request and submit
    it to the Wyoming Department of Health, Immunization Unit.
    Medical-Waiver-Request-ENGL-11.2021.pdf
    Religious-Waiver-Request-ENGL-8.2021.pdf
    Does your child have allergies of any kind?      *
    If yes please specify:   
    Has your child been diagnosed with any medical conditions?      *
    If yes please specify:      
    Does your child take any prescription medication?      *       
    If yes please specify:      

    Medication Dispensing Consent
    I,   *   *   , for the academic year, authorize Destiny Christian Academy’s nurse and staff permission to administer medication(s) as follows: (check all that apply)

     
       

      
       
       
     
       
       
       
       
                       

    Daily Medication

    • If your child requires prescription medication, it has to be accompanied with a written request from a physician and signed by a parent.
    • If your child requires daily OTC medication, they have to be accompanied with a written request and signed by a parent.
    • Additionally, the parent will need to fill out the Medication Dosage Card for both OTC and prescription medications.

    I will immediately notify the school of any changes to my child’s medical status. I understand that all students who show symptoms of communicable disease are to be excluded from classes until readmission is acceptable to school authorities. I will cooperate by keeping my child home during such times and informing the school of such. 


    *  Pick a Date*  

    • MS/HS Student Declaration 

    • Middle/High School Student Declaration

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    • Student Driver 

    • Student Driver Permission Form

    • At times, students with a valid driver's license may have the opportunity to drive themselves to official, school sanctioned activities that have been approved by a school administrator in lieu of using school transportation or having a parent/guardian transport them. It is recognized that only students who continue to demonstrate responsibility are extended a driving privilege to drive themselves to/from these activities.

      As the parent/guardian of {studentFull} I give permission for my child to drive him/herself to the following activity described below.

      ACTIVITIES (check all that you grant permission for your child to transport themselves to/from)
         
         
            
                  
      By signing below I understand and verify:

      • This permission only applies to the activities described above.
      • It is Destiny Christian Acadamy's expectation that the student will drive directly to and from the activity.
      • The student will wear a seat belt at all times and comply with all state driving laws and regulations.
      • My student has automobile insurance.
      • I consider my student to be a safe driver.
      • I am aware that Destiny Christian Academy is not able to prevent my student from driving to an unauthorized location.
      • I am aware that Destiny Christian Academy does not allow students to transport other students at any time. If this should occur, I understand my student has violated the expectations of Destiny Christian Academy and that Destiny Christian Academy may revoke driving privileges as a result.

      ASSUMPTION OF RISK AND WAIVER
      I acknowledge that transportation to and from the Activities carries risks of injuries to my child, including death, as well as damage to my vehicle and property. Regardless of such risks, I do hereby assume full responsibility for any risk of injury or loss due to the transportation to or from the approved Activities. I further release the Destiny Christian Academy Governing Board and its members, officers, agents, and employees, and assigns from any and all liability or cause of action arising from or by reason of any injury or loss that results from the transportation to or from the activities. I expressly agree that this release is intended to be as broad and inclusive as permitted by law and that if any portion of this release is held invalid, the balance shall continue in full force and effect.

      I understand that this release and waiver is effective only for the approved activities listed above.
      *   Pick a Date*   
      *   Pick a Date*   

      Driver’s License:   * Issuing State: *   
      Vehicle Information:
      *   *   *   *      

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  • Document Upload

  • Please upload any required documents below:

    • Pastor’s Letter of Recommendation
    • Recent Student Report Card
    • Current Immunization Record
    • Birth Certificate
    • Headshot photos of:
      • Student
      • Parent(s)/Guardian(s)
      • Authorized Student Release Contacts
    • Any additional documents you may want to add
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