GCA Fall Academies Registration

Geneva Classical Academy - Academies Registration
Student & Parent / Guardian Information
Student First Name
Student Last Name
Date of Birth

MonthDayYear
Date
Gender
Street Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
City
Zip Code
State
Grade
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Cell Phone
Format: (000) 000-0000.
Parent/Guardian Home Phone
Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Second Parent/Guardian First Name
Second Parent/Guardian Last Name
Second Parent/Guardian Cell Phone
Format: (000) 000-0000.
Second Parent/Guardian Home Phone
Format: (000) 000-0000.
Second Parent/Guardian Email
example@example.com
Emergency Contact Information
Primary Emergency Contact First Name
Primary Emergency Contact Last Name
Primary Emergency Relationship to Athlete
Primary Emergency Contact Cell Phone
Format: (000) 000-0000.
Does the student have any allergies that we need to be aware of?
Does the student have any other medical conditions that we need to be aware of?
Medical Release and Emergency Authorization

I, the undersigned parent/legal guardian, give permission for my child to participate in the Geneva Classical Academy Academy Program. I understand that participation in athletic and recreational activities involves inherent risks, including but not limited to falls, collisions, and other injuries that may occur during normal participation.

I certify that my child is physically able to participate in the activities associated with this program and that I have disclosed any medical conditions, allergies, medications, or other health concerns that may affect my child's participation.

In the event of an illness, injury, or medical emergency, I authorize Geneva Classical Academy staff, coaches, volunteers, and designated representatives to obtain emergency medical treatment for my child if I cannot be reached immediately. This authorization includes transportation by emergency medical personnel and treatment by licensed physicians, hospitals, or other healthcare providers as deemed necessary.

I understand that every reasonable effort will be made to contact me or my designated emergency contact before medical treatment is administered. I agree to assume responsibility for any medical expenses incurred as a result of my child's participation in this program.

By signing below, I acknowledge that I have read and understand this Medical Release and Emergency Authorization and voluntarily grant permission for my child to participate in the Academy Program.
Yes, I agree.
Parent / Guardian Signature
Geneva Athletics is excited to offer three fun after-school academies this fall! Academies will meet every Wednesday from September 9 through October 14, from 3:00–4:30 PM (Pep Squad will end at 4:15 PM). These programs provide students with opportunities to build skills, make friendships, and enjoy activities outside the classroom.
Dodgeball Academy

Join Coach Jess for an action-packed hour and a half of fun as students play a variety of dodgeball games and challenges. From classic dodgeball to creative team-based variations, this academy is perfect for students who love to stay active and compete in a fun environment.
Pep Squad Academy (K4-4th)

Students will learn cheers, chants, and school spirit traditions that support Geneva Athletics. Participants will also have the exciting opportunity to perform at Geneva's Homecoming Football Game on October 16, helping create an energetic atmosphere while cheering on the Knights.
Movie Madness Academy

Grab some popcorn and settle in for a fun-filled afternoon at Movie Madness Academy! Each week, students will enjoy a family-friendly movie while relaxing with friends and fresh popcorn. It's the perfect opportunity to unwind after school, share laughs, and make lasting memories in a comfortable, welcoming environment.
Academy Selection
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Dodgeball
$75.00



Pep Squad
$75.00



Movie Madness

$75.00



Total

$0.00
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Geneva Classical Academy - Academies Registration

Student & Parent / Guardian Information

Emergency Contact Information

Academy Selection*

Academy Selection