Continuous Enrollment Opt-Out Form

Continuous Enrollment Opt-Out Form

for 2026-2027 school year
Student(s) Name(s)*
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
Reason for Withdrawal
Statement of Withdrawal

I, the undersigned, hereby notify Awaken Christian Academy (ACA) of our intent to withdraw our student(s), from enrollment for the upcoming 2026-2027 academic year.

This notice is being submitted in writing before the January 20th deadline for withdrawal.

Should I choose to re-enroll our student(s) in the future, I understand that a $250 reinstatement fee (per student) will be applied.
I agree with the above statement*

Yes
Date*

MonthDayYear
Date
Signature*

Clear
Should be Empty: