Gray Road Christian Academy

  • "Free" Application for Admission

    Gray Road Christian Academy

  • Confidentiality & Information Protection Statement

    Gray Road Christian Academy is committed to protecting the privacy and confidentiality of all student and family information provided through this application and enrollment process.

    All personal, academic, medical, and legal information submitted will be used solely for educational, administrative, safety, and compliance purposes related to the student’s enrollment and participation at the Academy.

    Gray Road Christian Academy will not misuse, sell, distribute, or disclose personal information to unauthorized individuals or third parties, except as required by law or necessary to protect the safety and well-being of the student.

    Access to student records is limited to authorized school personnel with a legitimate educational interest. All records are maintained in accordance with applicable state and federal privacy regulations.

    By submitting this application, you acknowledge that the information provided is accurate to the best of your knowledge and understand that it will be handled with care, discretion, and professionalism.

  • STUDENT INFORMATION

    Please provide complete and accurate information for the enrolling student. This information will be used for academic placement, student records, communication, and emergency purposes.
  • Date of Birth*
     - -
  • Race*

  • Student Contact Information

  • PARENT / GUARDIAN INFORMATION

    Please provide complete and accurate parent/guardian information. This information will be used for official school communication, emergency contact, academic matters, and billing purposes.

  • Primary Parent/Guardian Information

  • Is this person the Primary Contact for school communication?*
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • Secondary Parent/Guardian Information (If Applicable)

  • Format: (000) 000-0000.
  • Is this person authorized for school communication and student pickup?

  • Custody & Legal Documentation

  • Does the student reside in a two-parent household?*
  • Is there a court order or custody agreement that affects (Check all that apply):*
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  • Custody Statement:

    Gray Road Christian Academy will provide equal access to educational records and communication to both parents unless legal documentation states otherwise. The Academy must have a current court order on file to enforce any custody restrictions or limitations regarding communication, decision-making, or student pickup.

  • FAITH & CHARACTER

  • Does the student know Jesus as their personal savior?*

  • ACADEMIC HISTORY & DISCIPLINE

  • Has the student ever repeated a grade?*
  • Has the student had any discipline problems in school? (i.e. suspensions or expulsions)*
  • Does the student have an IEP, 504 Plan, or learning accommodation?*
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  • MEDICAL INFORMATION

  • Does student have any mental, emotional, or physical handicaps or communicable diseases which may affect his/her activities or progress?*
  • Format: (000) 000-0000.

  • EMERGENCY AUTHORIZATION

    Whom should we call in case of illness or emergency if we cannot reach a parent/guardian?
  • Format: (000) 000-0000.

  • CONSENT & AUTHORIZATIONS

  • Student Image & Media Consent

  • Do you grant permission for student's image, video, or voice to be used in school-related media, including newsletters, websites, and social media?*

  • Education Philosophy

    I/we agree to support the Christian philosophy to which the Gray Road Christian Academy is committed and the rules and regulations by which the school is administered as contained in the Policy Handbook. I/we further understand that my/our child is expected to comply with and maintain the academic and behavioral standards as contained in the Policy Handbook. The administration, according to enrollment, staff availability, etc., will determine class size and grade combinations. All new students will be on probation for the first semester of attendance.

  • School Records Request Authorization

    I/we hereby authorize Gray Road Christian Academy to request academic, attendance, disciplinary, and testing records from the student's current or previous school. I/we understand that any information released will be held confidential between the sending school and Gray Road Christian Academy.

  • Medical Authorization

    I/we give consent for my/our child to participate in regularly scheduled activities sponsored by the school and to be transported to and from such activities. In the event of an emergency and I/we cannot be reached, I/we authorize Gray Road Christian Academy to seek emergency medical treatment for my/our child. I/we understand that reasonable efforts will be made to contact a parent/guardian immediately. I/we accept financial responsibility for any medical services rendered. I understand that unless I/we give other instructions hereon, my/our child would be transported to Children's Hospital if I/we cannot be contacted.
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