Elevate Edwards — Remote Math Program Registration

Register for Elevate Edwards — Remote Math Program
Elevate Edwards is offering a free remote math program for middle school students (grades 6–8) this summer. Students will work independently using Math Academy, an AI-powered platform, and can complete coursework from any device with internet access. Students who complete a full Math Academy course will earn $250.

This form must be completed by the parent or legal guardian. Because your child is a minor, we are required to obtain your consent before collecting their information and before sharing any data with our learning platforms. Please read each section carefully before continuing.
I am the parent or legal guardian of the student I am about to register, and I have reviewed the Elevate Edwards Privacy Policy.

Parent or Guardian Information
Parent or guardian full name

First NameLast Name
Relationship to student
Email address
example@example.com
Mobile phone
Please enter a valid phone number.Format: (000) 000-0000.
Mailing address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Preferred contact method
Preferred language

Student Information
Student's full legal name

First NameLast Name
Preferred name or nickname
Student's date of birth

MonthDayYear
Date
Grade entering Fall 2026
Current school
Gender
Primary language at home

Emergency Contacts and Authorized Pickup
Emergency Contact #1 — Full name

First NameLast Name
Emergency Contact #1 — Relationship to student
Emergency Contact #1 — Phone
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact #2 — Full name

First NameLast Name
Emergency Contact #2 — Phone
Please enter a valid phone number.Format: (000) 000-0000.
Authorized pickup persons

Health and Safety
Does your child have any allergies?
Please describe your child's allergies
Does your child have any medical conditions program staff should be aware of?
Please describe your child's medical conditions
Does your child take any medications during program hours?
Please describe medications taken during program hours
Pediatrician name
Pediatrician phone
Please enter a valid phone number.Format: (000) 000-0000.
Insurance carrier

Your consent to collect information from your child
To run this program, Elevate Edwards and our learning platforms will collect personal information from your child. This includes your child's name, date of birth, grade, school, and performance data generated as they use Math Academy, IXL/Reading Academy, Math Facts, and Reading Facts (questions answered, mastery levels, time on task, XP earned). We use this information only to deliver and improve the program and to report your child's progress to you. We do not sell your child's information. We do not allow advertising on our platforms. Full details are in our Privacy Policy.
I am the parent or legal guardian of the student named above. I provide my verifiable consent for Elevate Edwards to collect, use, and store personal information from my child for the purpose of operating this educational program, in accordance with the Children's Online Privacy Protection Act (COPPA).

Ed-Tech Platform Consents
My child will use the following platforms during the program. I have had the opportunity to review the privacy practices of each and consent to enrollment. Each platform is a separate consent.
Math Academy (mathacademy.com) — adaptive math curriculum. I consent to my child's enrollment.
IXL Learning (ixl.com), used to deliver our Reading Academy curriculum. I consent to my child's enrollment.
Math Facts — internal automaticity tool built and operated by Elevate Edwards. I consent to my child's use of this tool.
Reading Facts — internal fluency tool built and operated by Elevate Edwards. I consent to my child's use of this tool.

FERPA Records Release (Optional)
These two consents are optional and independent. You may grant either, both, or neither. Granting these consents allows Elevate Edwards instructors to better tailor the program to your child and lets Edwards Elementary see your child's summer progress.
I consent to Elevate Edwards receiving my child's academic records (grades, assessments, IEP/504 information as applicable) from Edwards Elementary, in accordance with FERPA.
I consent to Elevate Edwards sharing my child's progress data (mastery, attendance, instructor notes, XP totals) with Edwards Elementary at the conclusion of the program.

Photo and Media Release
Please choose ONE option below. Photo and media permission is separate from program enrollment — choosing not to grant permission will not affect your child's participation.
Photo and Media Permission

Your rights as a parent or guardian
As the parent or legal guardian, you have the right to: (1) review the personal information we and our platforms have collected about your child; (2) request that we delete that information; (3) refuse to allow further collection of information about your child; and (4) revoke any consent given on this form at any time. To exercise any of these rights, contact us at samuel.bennett@vailperformanceacademy.com. We will respond within 30 days. Note that revoking consent may affect your child's ability to continue participating in the program.
I have read and understand my rights as a parent or guardian, including my right to review, modify, or delete my child's information and to revoke my consent at any time.

Liability Waiver and Emergency Medical Authorization
Elevate Edwards is a structured morning program that includes indoor instruction, supervised outdoor movement breaks, and group activities. As with any in-person youth program, participation carries some inherent risk of injury or illness. Elevate Edwards takes reasonable steps to keep every child safe, including a 15:1 student-to-teacher ratio, trained staff, and the health and safety information you have provided on this form. By signing this form, you acknowledge that you understand these risks and that you are voluntarily enrolling your child in the program. To the fullest extent permitted by Colorado law, you, on behalf of yourself and your child, release and agree not to hold liable Elevate Edwards, Vail Performance Academy, and their staff, instructors, and volunteers for claims of ordinary negligence arising from your child's participation. This release does not apply to gross negligence or to willful or reckless conduct. If your child is injured or becomes ill during the program and you and your listed emergency contacts cannot be reached, you authorize Elevate Edwards staff to secure appropriate medical care for your child, including transport to a medical facility if necessary, and you agree to be responsible for any resulting medical or transportation costs. Staff will always attempt to reach you and your emergency contacts first.
I have read and understand the risks described above. On behalf of myself and my child, I voluntarily accept those risks and release Elevate Edwards, Vail Performance Academy, and their staff, instructors, and volunteers from liability for ordinary negligence, to the fullest extent permitted by Colorado law.
I authorize Elevate Edwards staff to obtain emergency medical care for my child if I and my listed emergency contacts cannot be reached, and I understand I am responsible for any resulting medical or transportation costs.
Confirm and Sign
I confirm I am at least 18 years old and I am the legal parent or guardian of the student named on this form.
I certify that all information provided on this form is true and complete to the best of my knowledge.
Signature of Parent/Guardian
Printed name
Date of submission

MonthDayYear
Date
Should be Empty:

Register for Elevate Edwards — Remote Math Program

Parent or Guardian Information

Student Information

Emergency Contacts and Authorized Pickup

Health and Safety

Program Logistics

Your consent to collect information from your child

Ed-Tech Platform Consents

FERPA Records Release (Optional)

Photo and Media Release

Your rights as a parent or guardian

Liability Waiver and Emergency Medical Authorization

Confirm and Sign