Kingdom Learning Alliance Registration Form
Parent Full Name
*
First Name
Last Name
Student(s) Name / Birthday
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Entering Grade(s):
*
PEP/ UA or Self Pay
*
Does your student have a documented Unique Ability? Yes or No. If yes, what is it?
*
Are there any medical concerns/conditions/allergies we need to be award of?
I will read the Student-Family Handbook and support full compliance with its rules, as well as all other written school policies.
I understand that I am responsible for maintaining all relevant home school documentation regarding my child's academic progress.
I understand that the $50 application fee per child, and class tuition fees are non-refundable. Tuition fees are transferable at KLAs discretion.
The co-op has my/our authorization to seek medical care for my/our child in the event of serious illness or accident if I/we, the parents, can not be reached.
I give my child permission to participate in all school activities and release Kingdom Learning Alliance, its staff, and the host site from liability, except in cases of gross negligence.
I understand that I am fully responsible for and agree to pay my financial obligations in accordance with the financial agreement policy set forth by the Co-op. I understand that if I do not meet my financial obligations, my student will be withdrawn from Kingdom Learning Alliance.
I give permission for my child to participate in all school activities and release Kingdom Learning Alliance, staff, and the host site from liability, except in cases of gross negligence.
Please note: Student photos may be used on the KLA website and in promotional materials such as flyers, social media posts, and event programs. By enrolling, you give permission for your child’s images to be used for these purposes.
Signature
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