New Student Registration

Student Registration
Full Name*

First NameLast Name
Birthday*

MonthDayYear
Date
Gender*
Grade Entering in the fall*
Current Academic Level*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian*

First NameLast Name
Phone Number*
E-mail
example@example.com
Parent/Guardian #2

First NameLast Name
Phone Number
E-mail
example@example.com
Emergency Contact (besides a parent):
Cell Number
Please enter a valid phone number.
The following people (besides parents & emergency contact) have permission to pick up (also include anyone NOT allowed):
If any of the above list changes through the year please send an email or text at least 24 hours before pick up.
Child Medical Provider & Doctor Name
Health Insurance Provider
Health Insurance Policy Number
List of any allergies and/or medications and if taken during class hours:
Please list any special needs for your child academically, socially or behaviorally and what has or hasn't worked well in their past learning environments:
Anything else you would like Big Dreams Academy to know:
At Big Dreams! Academy we will always keep your children safe however we know accidents can happen. Throughout the year we will be walking to the park, driving places for field trips (myself and other teachers), science experiments, cooking, etc so please mark below you agree to our liability release form:
Please read through our Academy policies. There is also a Parent Handbook for more detailed information that is available upon request.
Sign here to state you've read and agree to the Liability Release Form and Academy Policies

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At Big Dreams! Academy we keep the tuition cost low in order to prioritize families and make private education available and affordable to as many as possible. (this does not include charter funding)
I am wanting my child to attend:*

1 day a week2 days3 days4 days5 daysHalf days
Please Select one:*

I agree to paying the monthly tuitionI will be paying the full year tuition
Name of Charter my student is enrolled in/applied for
Charter monthly funding (if already accepted)
I agree to:

Use Big Dreams! Academy as a Vendor for my charter school fundsLook into charter schoolsNone apply to me at this time

Registration Fee(non-refundable)

$50.00 Quantity

Total

$0.00

Credit Card

Thank you for applying!

You wil hear back within 2-3 business days about acceptance or if you haven't toured yet please message the office. If our space is full you will receive a message about being put on a waiting list.
Should be Empty: