GBA Registration Form

Great Beginnings Academy of Orlando

Student Registration Form
Student Information
Student Name

First NameMiddle NameLast NameSuffix
Social Security Number
Gender
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Place of Birth
Race
Ethnicity
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Applying for Grade Level

Great Beginnings Academy of Orlando

Student Registration Form
Parent/Guardian 1 Information
Parent/Legal Guardian 1 Name

PrefixFirst NameMiddle NameLast NameSuffix
Relationship to Student
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Does the student live with you?
Employer

Great Beginnings Academy of Orlando

Student Registration Form
Parent/Guardian 2 Information
Parent/Legal Guardian 2 Name

PrefixFirst NameMiddle NameLast NameSuffix
Relationship to Student
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Does the student live with you?
Employer

Great Beginnings Academy of Orlando

Student Registration Form
Emergency Contacts & Authorized Pick-Up Persons

In case of an emergency or school closure, please provide the names, addresses, and phone numbers of individuals we may contact if we are unable to reach a parent or guardian. The individuals listed below are also authorized to pick up your child(ren) from Great Beginnings Academy of Orlando without any additional authorization during the school year. If someone not listed below needs to pick up your child on any given day, the parent or guardian must notify the school in advance by phone, and the individual must present a valid photo ID prior to the release of the child. If you wish to remove an individual from your child’s authorized pick-up list at any time during the school year, the request must be submitted in writing via email to info@gbaorlando.com. Changes to the authorized pick-up list will not be made verbally.
Emergency Contact #1

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Student
Emergency Contact #2

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Student
Emergency Contact #3

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Student

Great Beginnings Academy of Orlando

Student Registration Form
Academic History

Previous schools student attended
School Name
Grades Attended
Has the student been retained in any grade?
If yes, what grade and please explain
If not applicable, please enter "N/A".
Has the student been suspended and/or expelled
If yes, what grade and please explain
If not applicable, please enter "N/A".
Do any of the following apply to the student?
If any of the above is checked “Yes”, comment below (if applicable, indicate the name and frequency of medication).
If not applicable, please enter "N/A".

Document Submission
Please upload the students Birth Certificate, Latest Physical, Immunization Records, and Previous Schools Transcripts if applicable.

Cancelof

Great Beginnings Academy of Orlando

Student Registration Form
Custody
In rare instances a child may be designated as “Protected” if a court has issued a restraining order under the Child Welfare Act, the Domestic Relations Act, the Divorce Act, or the Young Offenders Act. Please indicate if the school administration should be aware of any such Court Order for the protection of your child. If yes, please make arrangements to discuss this situation with the school administration. Legal documentation will be required.
Media Release
I hereby authorize the picture taking/videotaping of my child

Student First Name*   Student Last Name*

and/or the release of his/her name and achievement(s) for educational and bona fide
related purposes, and consent to the showing of these to any persons. I also authorize the use of videotape/pictures and/or other information in printed matter or other media for presentation of Great Beginnings Academy of Orlando without further consent from me. I agree such pictures and others forms of media shall be the property of Great Beginnings Academy of Orlando.

Signature*   Date*

Great Beginnings Academy of Orlando

Student Registration Form
Parent Partnership Agreement

This agreement outlines the shared expectations and responsibilities between Great Beginnings Academy of Orlando and each family we serve. By signing below, the parent/guardian acknowledges and agrees to the policies, procedures, and commitments outlined regarding student participation, conduct, safety, and financial responsibility while enrolled at Great Beginnings Academy of Orlando.
School Trips
I give Great Beginnings Academy of Orlando permission for my child to participate in all school-related activities, including bus trips, sporting events, field trips, and other school-sponsored activities that take place away from school premises.

Discipline
I understand that discipline is necessary for the well-being and safety of each student, as well as for the school community as a whole. I give permission for my child’s teacher and the administration of Great Beginnings Academy of Orlando to establish and enforce classroom and school regulations in a manner consistent with school policies and procedures.

Student Injury / Liability
I understand that participation in school activities may involve certain risks. I agree to release and hold harmless Great Beginnings Academy of Orlando, its staff, employees, and representatives from liability for any injury or alleged injury involving my child while participating in school activities, except where caused by gross negligence or willful misconduct.

Should any legal action be brought against Great Beginnings Academy of Orlando, its employees, or representatives on behalf of my child, and the school or its representatives are found not to be at fault, I understand that I may be responsible for attorney fees, court costs, or other related expenses incurred in defense of such action, as permitted by law.

Financial Agreement
I understand that all registration fees paid to Great Beginnings Academy of Orlando are non-refundable.

If I choose to withdraw my child during the school year, I agree to provide at least two (2) weeks’ written notice to the school.

I further understand that if my child attends one or more days of any academic quarter, I am financially responsible for the full tuition amount for that quarter.

I understand that all financial obligations to Great Beginnings Academy of Orlando must be satisfied before student records, transcripts, or other official documents will be released.

This Parent Partnership Agreement shall remain in effect for as long as my child(ren) is/are enrolled at Great Beginnings Academy of Orlando.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Great Beginnings Academy of Orlando

Student Registration Form
Tuition and Fees
By signing below, I acknowledge that I have reviewed and understand the tuition and fee schedule for Great Beginnings Academy of Orlando and agree to assume full financial responsibility for all tuition, registration fees, and any additional charges associated with my child’s enrollment. I understand that tuition is assessed on a quarterly basis and represents a financial obligation to the Academy. If my student attends at least one (1) day during any academic quarter, the full quarterly tuition payment is due and non-refundable, and tuition will not be prorated for partial attendance, withdrawal, dismissal, or scholarship changes. If my student is withdrawn prior to the start of a new quarter and does not attend any portion of that quarter, I will not be held responsible for that upcoming quarterly payment. I agree to provide the school with a minimum of two (2) weeks written notice prior to withdrawing my student; however, failure to provide timely notice does not waive financial responsibility if the student attends at least one day of the quarter. I acknowledge that all registration and enrollment fees are non-refundable and non-transferable under any circumstances. If my child participates in a Step Up for Students scholarship program (including FES-EO, FES-UA, HOPE, or any applicable scholarship), I understand that I am responsible for completing and maintaining all scholarship requirements, approving quarterly scholarship payments in a timely manner, and ensuring continued eligibility. I further understand that if scholarship funds are delayed, reduced, denied, or revoked for any reason, I remain fully responsible for any unpaid tuition balance. I acknowledge that failure to remain current on tuition and fees may result in late fees, suspension of services, withholding of report cards or student records, and/or withdrawal from enrollment in accordance with school policy, and I accept full financial responsibility for any outstanding balance owed to Great Beginnings Academy of Orlando.
Tuition Payment Method
Step Up Award ID
If applying for a Step Up for Students scholarship, the Award ID will be provided once your application has been approved. If selecting Private Pay (Self-Pay), please write “N/A” in the space above.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate

Great Beginnings Academy of Orlando

Student Registration Form
Authorization

I understand and agree that admission and continued enrollment at Great Beginnings Academy of Orlando are contingent upon compliance with school policies and the timely payment of all tuition and applicable fees.
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Registration Fee
prevnext( X )
Registration Fee
A non-refundable registration fee of $100 is required for the first child enrolled. Each additional sibling enrolled at the time of registration will incur a $50 non-refundable registration fee.

Fee Schedule:

• 1 Child — $100

• 2 Children — $150

• 3 Children — $200

Each additional child after the first is $50.

$100.00 Number of children being enrolled
Item subtotal:$0.00

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

Great Beginnings Academy of Orlando

Student Information

Great Beginnings Academy of Orlando

Parent/Guardian 1 Information

Great Beginnings Academy of Orlando

Parent/Guardian 2 Information

Great Beginnings Academy of Orlando

Emergency Contacts & Authorized Pick-Up Persons

Great Beginnings Academy of Orlando

Academic History

Document Submission

Great Beginnings Academy of Orlando

Custody

Media Release

Great Beginnings Academy of Orlando

Parent Partnership Agreement

Great Beginnings Academy of Orlando

Tuition and Fees

Great Beginnings Academy of Orlando

Authorization

Registration Fee

Payment Methods