• ''Where we believe every child should have a chance to have a chance''

    ''Where we believe every child should have a chance to have a chance''

  • IGNITE Academy

    Registration Form

    Inspire Growth, Nurture Innovation, Transformative Experience

  • IGNITE Acadmey Pathways

    Please select the program listed below that your child will be the most interested in.

  • Pick Your Program

  • Students First Option
  • Students Second Option
  • Electives: Pick Top Three

  • Student Information

    Student Information
  • Relationship to Student*
  • Student Birth Date*
     - -
  • Student Gender*
  • Ethincity*
  • Primary Language*
  • Name of School Student Attends*

  • Contact Information

    Applies to Parent and Student
    Contact Information
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.


  • Does you child live with you?*
  • What is your preferred method of communication for program updates and information?(For both the student and parent)*

  • Emergency Contact Information

    In the event of an emergency, please list one person we may contact who knows your child and can take full responsibility should you not be available
  • Relationship to student*
  • Format: (000) 000-0000.

  • Medical Information

    Medical Information
  • Does your child take any medication during program hours?*

  • Pre-Program Evaluation

    This evaluation will help us get to know you anfd your child.
  •
  • 2.)Has your child participated in the IGNITE Academy in the past?*
  • 4.) How did you learn about the IGNITE Academy?*
  • 6.) What values or qualities do you hope the program will help instill in your child?*
  • 7.) What are your child's areas of interest? ( Check all that apply)*
  • 8.) Does your child have any prior experience in the activities listed above?*
  • 10.) How would you describe your child’s learning style?*
  • 11 .) Do you foresee any barriers that might prevent your child from fully participating in the program (e.g., transportation, scheduling, etc.)?*
  • 12.) Is your child currently participating in other extracurricular activities*
  • 13.) Does your child have any special needs or accommodations we should be aware of?*
  • 14. Do you have safety concerns for your child when participating in the IGNITE Academy?*
  • 15.) How involved do you plan to be in your child’s journey through the program?*
  • 16.) Does your child attend summer programs or camps?*
  • 17.) Have you or your family participated in other programs or services offered by Community Matters 2, Inc.?*

  • Thank You!

    Thank you for completing this evaluation! This helps us get to know your child better and provide the best experience possible.

  • Parental Consent

  • Informed Consent & Acknowledgement
    Emergency Medical Authorization
    In the event of a medical emergency, I authorize Community Matters 2, Inc. to call 911 and seek emergency treatment for my child if I or my listed emergency contacts cannot be reached.

    Media Release
    I give permission for Community Matters 2, Inc. to use photos, videos, or other media containing my or my child’s image for promotional or other appropriate purposes. I release CM2 and its representatives from any claims related to such use.

    Accident Waiver & Liability Release
    By participating in this program, I release Community Matters 2, Inc., its staff, volunteers, and partners from any claims related to injury, illness, or loss during or related to the program, including travel. I understand and accept all risks and agree not to hold CM2 responsible. This release applies to the fullest extent allowed by law.

    I acknowledge that I have read, understand, and voluntarily agree to the terms stated above.

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