• Mercy Prep Fall Friday Class Registration - Homeschool

  • Parent/Guardian Information - Primary

  • Format: (000) 000-0000.
  • Custodial Rights?*
  • Emergency Contact?*
  • Financially Responsible?*
  • Authorized Pick-up?*
  • Do custodial parents consider themselves Christians?*
  • Are you a member of your current church?*

  • Parent/Guardian Information - Secondary

  • Format: (000) 000-0000.
  • Custodial Rights?
  • Emergency Contact?

  • Student Information - 1st Student

  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Authorized Driver?*
  • Friday - Option 1
  • Friday - Option 2

  • Student Information - 2nd Student (If applicable)

  • Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year
  • Authorized Driver?
  • Friday - Option 1
  • Friday - Option 2

  • Student Information - 3rd Student (If applicable)

  • Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year
  • Authorized Driver?
  • Friday - Option 1
  • Friday - Option 2

  • Student Information - 4th Student (If applicable)

  • Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year
  • Authorized Driver?
  • Friday - Option 1
  • Friday - Option 2

  • *Customer payment data is handled directly by Stripe Payment Processing's secure systems and is encypted and fraud compliant.

  • My Products*

    prevnext( X )
        Friday Class Payment
        $225.00$225.00
          
        One Act Play

        If your student is selected to be apart of the OAP team, Mercy Prep will bill you $295. 

        Free$ Free
          
        Total
        $0.00$0.00
        Debit or Credit Card
      • I agree to hold harmless and indemnify Mercy Preparatory Academy from any and all claims, liabilities, damages, and expenses that may arise from my child's participation in physical education, athletics, recess, or any other physical activity on or off campus.  Agreement required.*
      • I agree to the use of my image or my children's image to be utilized in marketing materials such as our website, brochures, social media, and other similar publications.  Approval required.*
      • Date Signed*
         - -
        2 digit month, 2 digit day, 4 digit year

      • Once you submit your registration, we will send you our Fine Arts Handbook that must be signed and returned prior to registration being complete. (If you have participated in a Friday Class or sports with us this year, you will not be required to sign it again).

      • Should be Empty: