Registration New Families 2025-26 School Year

Registration 2025-2026

Santa Cruz Learning Center
Welcome to the Santa Cruz Learning Center Registration Page!

If you’re registering a returning student and there are no changes to your personal or medical information, you can save time by completing your registration here—no need to re-enter everything!

If this is your first year with Santa Cruz Learning Center, please continue with the form below.

We’re excited to have you join our community!
Participant Name (Student):

First NameLast Name
DOB of Student:

MonthDayYear
Date
Age of Student as of September 2025
Grade level Fall 2025
School (Ocean Grove, AFE, or enter homeschool, if the student is not registered to a school, etc.)
Student Email: Middle and high school students are asked to provide a personal email address so we can communicate about grades and assignments. Please do not enter a parent email here.
example@example.com
Cell Phone for student, if applicable. Please do not enter a parent cell phone here.

Area CodePhone Number
Info for Parent or Guardian 1
Parent or Guardian 1 Full Name:

First NameLast Name
Does the student live full time with parent or guardian 1? If no, please describe when the child stays with parent or guardian 1.
Parent/Guardian 1 Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship(s) of parent or guardian 1 to the student (mother, father, etc.)
Cell phone number of parent/guardian 1

Area CodePhone Number
Work phone of parent/guardian 1

Area CodePhone Number
Email for parent/guardian 1
example@example.com
Info for Parent or Guardian 2

Leave blank if only Parent or Guardian 1 is the only Parent or Guardian
Parent or Guardian 2 Full Name:

First NameLast Name
Does the child live full time with parent or guardian 2? If no, please describe when the child stays with parent or guardian 2.
Parent or Guardian 2 address Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship(s) of parent or guardian 2 to the student (mother, father, etc.)
Cell phone of parent/guardian 2

Area CodePhone Number
Work phone of parent/guardian 2

Area CodePhone Number
Email for parent/guardian 2
example@example.com
Participant Information

Tell us a little about the student
Has your child been diagnosed with any learning exceptionalities and do they have an IEP or a 504 plan?
If you answered yes to the question above, please provide us with more information. If applicable, could you share their IEP or 504 plan report with our education team? Do you have specific tools and/or learning/teaching strategies that have been successful? Are there accommodations that we should be aware of?
Has your child ever been asked to leave an educational or extracurricular class or program due to behavioral issues? If yes, please describe below. If no, please enter no.*
What is the name of your ES or Educational Consultant?
Education Specialist/Consultant Email
example@example.com
Emergency Contact Information

Please let us know who to contact in the event of an emergency if we are unable to reach Parent or Guardian 1 or 2.
Emergency Contact 1:

First NameLast Name
Phone Number:

Area CodePhone Number
Relationship to Student:
Emergency Contact 2:

First NameLast Name
Phone Number:

Area CodePhone Number
Relationship to Student:
Emergency Contact 3:

First NameLast Name
Phone Number:

Area CodePhone Number
Relationship to Student:
Payment Options:
Fees are listed by the semester, and families may choose one of the following payment methods:
- Pay in full at the beginning of the course and receive a $20 discount per class
- Split the semester fee into five monthly payments
- Ocean Grove Charter School families using instructional funds
  - Will be billed monthly through their purchase order (PO) and are not eligible for the $20 discount.
  - Please ask your Education Specialist (ES) to generate a PO for the full semester price of your selected course(s).
How do you plan to pay for course fees from Santa Cruz Learning Center?

Pay with Ocean Grove PO (Please notify yourES to prepare a purchase order. If you select this option, we must receive a PO from OG before you start classes.)Pay monthly - This will require that you complete a payment agreement form and funds will be automatically withdrawn on the first of each month.Pay in full at the beginning of the semester and receive a discount of $20 per class.Some combination of purchase order and self pay.Other
If paying by self-pay (not by purchase order), who is the person responsible for payment of course fees at Santa Cruz Learning Center?

First NameLast Name
What is the email of the person financially responsible for course fees?
example@example.com
Phone number of financially responsible person

Area CodePhone Number
Medical Insurance Information
Medical Insurance Carrier
Name of Insured
Policy Number
Group Number
Name of Primary Care Physician:
Phone number of Primary Care Physician

Area CodePhone Number
Name of Dentist:
Phone Number of Dentist:

Area CodePhone Number
Health Information
Does your child take medication?

yesno
If your child takes medication, please specify with details.
Does your child have asthma?

YesNo
Does your child carry an inhaler for their asthma?

YesNo
Has your child been diagnosed with ADD or ADHD?

YesNo
Is your child allergic to any of the following? Please select all that apply

Bee StingsAnimalsTrees, grasses, pollenFoodsMy child does not have allergies to bees, animals, trees, grasses, pollen or foods.
If you answered yes to any allergies, please describe the reaction and the severity of the allergies that you indicated.
Does your child carry an epipen?

YesNo
Are there any other health or behavioral conditions or information that you would like to share with us? If so, please describe below.
COURSE ENROLLMENT
Registering Multiple Students?

Please complete a separate form for each student you are registering.
Flexible Attendance Options

Unless otherwise indicated, all of our high school and middle school courses are available both in person at Santa Cruz Learning Center and live via Zoom. Students and families can choose the format that best fits their needs. You're welcome to attend:
- Fully in-person
- Fully live, via Zoom
- Or switch between the two formats as needed
All Elementary classes are only available in person.
How do you plan to attend classes at SCLC?

Fully in-personFully live, via ZoomA combination between in person and ZoomI'm not sure yet
Please select class options from the choices below
Categories:All

All

Elementary Courses

Middle School Courses

High School Courses
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Elementary Courses

Adventures in Science$650
1-2nd Grade & 3rd-5th Grade with Jenn Tuesdays 1:00 pm-3:00 pm

American Sign Language for Kids$400
K-5 grade with Melanie Mondays 12:10 pm - 1:10 pm

Beneath the Waves$550
Ocean Life and Science Below the Sea with Jenn 5th-6th grade Thursdays 1:45 pm-3:15 pm

Beyond the Book Readers Workshop$650
Elementary students reading at the 3rd-grade level or higher. With Melanie Wednesdays 10:00 am - 12:00 pm

California History and US Geography$650
4th-5th grade with Tiffany Wednesdays 12:30 pm - 2:30 pm

Everything Class: K-2$650
Project Combo Class for K-2nd Graders with Melanie Mondays 10 am-12 pm

Everything Class 2nd-4th$900
ONE DAY PER WEEK Project Combo Class with Jenn for 2nd-4th Graders TUESDAYS OR THURSDAYS

1 Day Per Week

Everything Class 2nd-4th$1,700
TWO DAYS PER WEEK Project Combo Class with Jenn for 2nd-4th Graders TUESDAYS & THURSDAYS

Number Ninjas Math Group$650
3rd & 4th Grade with Jenn Tuesdays and Thursdays 12 pm - 1 pm

Writing Wonderlab: Young Writers Workshop$525
3rd-5th grade with Jenn Thursdays 1 pm - 2:30 pm

Middle School Courses

Algebra 1/Integrated Math 1$650
9th grade math, all grades welcome, based on math skill level. with Malika Tuesdays and Thursdays 9am-10:10am

American Sign Language 1$650
with Melanie 6th-12th grade Mondays and Wednesdays 2:15pm-3:15pm

Beneath the Waves$550
Ocean Life and Science Below the Sea with Jenn 5th-6th grade Thursdays 1:45 pm-3:15 pm

Cultural Anthropology & World Geography$650
with Jenn 6th-8th grade

Language Arts$650
6th-8th grade with Jenn Wednesdays 10:15pm-12:15pm

Math Course 2 $650
with Malika 7th grade math, but all grades welcome based on math skill level.

Pre Algebra/Math Course 3$650
with Malika 8th grade math, but all grades welcome based on math skill level.

Physiology and Forensics$700
This class is FULL. Select this option to be placed on the WAITING LIST with Malika 6th-8th grade

US History and Geography$650
with Tiffany 6th-8th grade

Young Chemists$700
with Malika 7th & 8th grade

High School Courses

Algebra 1/Integrated Math 1$650
9th grade math, all grades welcome, based on math skill level. with Malika Tuesdays and Thursdays 9am-10:10am

American Sign Language 1$650
with Melanie 6th-12th grade Mondays and Wednesdays 2:15pm-3:15pm

ALGEBRA 2/INTEGRATED MATH 3 $650/SEMESTER$650
With Malika Bell Mondays and Wednesdays 9am-10:10am We are transitioning into the integrated math format. This course is recommended to be taken after completing Integrated Math 2 or after taking Algebra 1 and Geometry.

Adulting 101$500
With Jay Dane Tuesdays 11:30am-1pm

Biology with Lab$700
With Malika Bell Wednesdays 11:45am-2:15pm

Chemistry with Lab$700
With Malika Bell Thursdays 11:45am-2:15pm

Earth Science with Lab$700
With Jay Dane Tuesdays 1:45pm-4pm

English 10- Project Based$650
With Jay Dane Mondays 11:30am-1:30pm

"Fun"ctional English$650
With Jay Dane Thursdays 11:30am-1:30pm

Geometry$650
With Malika Bell Mondays and Wednesdays 10:15am-11:25am

Government$650
With Jay Dane (LIVE ZOOM CLASS ONLY, will have Economics in the Spring) Wednesdays 2pm-4pm

Physics with Lab$700
With Malika Bell Fridays 10am-12pm

Pre Algebra/Math Course 3$650
with Malika 8th grade math, but all grades welcome based on math skill level.

US History$650
Project-Based With Jay Dane Thursdays 2:15 pm - 4:15 pm

World History$650
Project-Based With Jay Dane Mondays 1:45 pm-3:45 pm
RELEASE SECTION
Photo and Video Release: Santa Cruz Learning Center may occasionally take photos or videos of students during classes and events for use in promotional materials (e.g., website, flyers, or social media). Do we have your permission to use photos or videos of your child for promotional purposes?*

Yes, I give permission to Santa Cruz Learning Center to use photos and/or videos of my child.No, I do not give permission to use photos or videos of my child.Other
Financial Responsibility: The parent or guardian signing this form agrees to be financially responsible for all fees owed to Santa Cruz Learning Center under this agreement. Please sign below to indicate that you have read and agree to these terms.*

Clear
Supervision Policy: Santa Cruz Learning Center is responsible for your child only while they are in class. Elementary students will be supervised until an approved adult arrives for pickup. Middle and high school students attending multiple classes with breaks in between will have access to a designated space at the center where they can wait quietly and independently. If you have any concerns, please discuss rules and boundaries with your child and their instructor(s) to ensure expectations are clear. Please sign below to indicate that you have read and agree to these terms.*

Clear
Emergency Medical Authorization: In the event of illness or accident, I authorize the Santa Cruz Learning Center to secure emergency medical treatment for my child (or myself, if applicable) as deemed necessary. I understand that I am responsible for any resulting medical expenses. Please sign below to indicate your agreement with these terms.*

Clear
Behavior and Dismissal Policy: The Santa Cruz Learning Center reserves the right to dismiss any participant who does not show respect for the facility, including—but not limited to—disrespect toward property, equipment, policies, other students, volunteers, or staff. Participants who are dismissed for behavioral reasons will not receive a refund of fees paid. Please sign below to indicate your agreement with these terms.*

Clear
Liability Waiver and Release: The Santa Cruz Learning Center and its employees, independent contractors, and volunteers assume no responsibility for personal property. By signing this enrollment form, I (we) hereby waive any and all claims against the Santa Cruz Learning Center and its employees, independent contractors, and volunteers. I understand and agree that, by signing this agreement, I am relinquishing my right (or the rights of the minor for whom I sign) to make any claim—including the right to sue—for bodily or personal injury, property damage, or any other loss that may occur while participating in or using Santa Cruz Learning Center services, except as limited by law. Please sign below to indicate your agreement with these terms.*

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Name of person signing this registration form

First NameLast Name
Should be Empty:

Registration 2025-2026

Info for Parent or Guardian 1

Info for Parent or Guardian 2

Participant Information

Emergency Contact Information

Medical Insurance Information

Health Information

COURSE ENROLLMENT

RELEASE SECTION