Going To Another Level Enrollment Form

Program Enrollment Form

These forms are required for your children to attend the program
PLEASE NOTE THAT EVERYTHING THAT HAS A RED * NEXT TO IT MUST BE COMPLETED IN ORDER TO COMPLETE THE ENROLLMENT PROCESS.
Child's Information
Child's Name #1*
Date of Birth*

MonthDayYear
Age *
What is the name of child's school they attend?*
PLEASE TYPE N/A IF THIS DOESN'T APPLY
What are the child's school hours?*
PLEASE TYPE N/A IF THIS DOESN'T APPLY
How did you here about us? *
Entering Grade in 2023-24*
PLEASE SELECT N/A IF THIS DOESN'T APPLY
Please select which service your child will need*
What is the child's anticipated start date?*

MonthDayYear
Date
Program Sport Interested In?*
PLEASE SELECT OTHER IF THIS DOESN'T APPLY
T-Shirt Size*
Upload a Picture of your child's Birth Certificate (If available)

Please email to gtalathletics@gmail.com prior to your child's start date if necessary
Cancelof
Upload a passport size color Picture of your child *

Please email to gtalathletics@gmail.com prior to your child's start date if necessary
Cancelof
Child's Swimming Ability

Non-SwimmerBeginner Swimmer (can swim on front 20ft without flotation)Advanced Swimmer (can pass swim test)
Please provide any additional information that you think is important or may affect the child's ability to fully participate in the program.
Child's Name #2 (If Applicable)
Date of Birth

MonthDayYear
Age
What is the name of child's school they attend?
Entering Grade in 2023-24
What is the child's anticipated start date?

MonthDayYear
Date
What are the child's school hours?
Program Elective Interested In?
T-Shirt Size
Upload a Picture of your child's Birth Certificate (If available)

Please email to gtalathletics@gmail.com prior to your child's start date if neccessary
Cancelof
Upload a passport size color photo of your child

Please email to gtalathletics@gmail.com prior to your child's start date if neccessary
Cancelof
Child's Swimming Ability

Non-SwimmerBeginner Swimmer (can swim on front 20ft without flotation)Advanced Swimmer (can pass swim test)
Please provide any additional information that you think is important or may affect the child's ability to fully participate in the program.
Child's Name #3 (If Applicable)
Date of Birth

MonthDayYear
What is the name of child's school they attend?
Age
What is the child's anticipated start date?

MonthDayYear
Date
How did you hear about us?
What are the child's school hours?
Entering Grade in 2023-24
Program Elective Interested In?
T-Shirt Size
Upload a photo of your child's Birth Certificate (If available)

Please email to gtalathletics@gmail.com prior to your child's start date if necessary
Cancelof
Upload a passport size color photo of your child

Please email to gtalathletics@gmail.com prior to your child's start date if neccessary
Cancelof
Child's Swimming Ability

Non-SwimmerBeginner Swimmer (can swim on front 20ft without flotation)Advanced Swimmer (can pass swim test)
Please provide any additional information that you think is important or may affect the child's ability to fully participate in the program.

Parents' Information

Parent/Guardian 1
Parent/Guardian 1*

First NameLast Name
Relationship to Child*
E-mail*
example@example.com
Cell Phone*
Network Carrier *
ex. At&t
Upload Picture of Parent Photo Driver License *

Cancelof
Home Phone*
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Work/School Name*
Or enter N/A if not applicable
Parent's Work/School Phone
Parent's Work/School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Where would you like to be reached while your child is at Program Site?*

Cell PhoneWork PhoneHome Phone
Heading

Parent/Guardian 2
Parent/Guardian 2

First NameLast Name
Relationship to Child
E-mail
example@example.com
Cell Phone
Network Carrier
ex. At&t
Home Phone
Home Address Same as Parent/Guardian 1?

Yes
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Work/School Name
Or enter N/A if not applicable
Parent's Work/School Phone
Parent's Work/School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Where would parent/guardian 2 like to be reached while your child is at the Program?

Cell PhoneWork PhoneHome Phone

Emergency Contacts/Authorized Pickup

Parents cannot be listed as emergency contacts. List the name of at least one person who can be contacted in the event of an emergency or illness if you cannot be reached. Any person listed should be able to assist in contacting you. At least one person listed must be within one hour of the center/home, able to take responsibility for the child in case the parent/guardian cannot be contacted and should be at least 18 years of age. The first emergency contact must live no more than 1 hour away and be over the age of 18. If your child is NOT picked up by 7:00 pm, you'll be charged a late fee of $1.00 per minute beginning at 7:31 pm.
Heading

Emergency Contact #1
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Network Carrier *
ex. At&t
Secondary Phone Number*
E-mail*
example@example.com
Relationship to Child*
Emergency Contact #2
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*
Secondary Phone Number*
Network Carrier *
ex. At&t
E-mail*
example@example.com
Relationship to Child*

The Going To Another Level has permission to secure emergency transportation for my child in the event of an illness or injury which requires emergency treatment. The emergency transportation service will determine the facility to which my child will be transported.*
Type first and last name above to consent
I am aware that pictures of my child may be taken at Going To Another Level during the Program. I am aware that pictures may be posted to the website, social media. The pictures will be used for the purpose of illustrating the activities at Going To Another Level. Pictures posted to the website or in the facility are considered the property of GTAL and may not be sold or reused without the express consent of the GTAL. Parents who have special concerns or requirements regarding photography of their children agree to contact Administrator (Coach Sherita) at 301-531-4747 in advance of the program activities to resolve any comments or concerns regarding the use of your child’s photographs or photography.*
Type first and last name above to consent
The Going To Another Level has permission to secure emergency transportation for my child in the event of an illness or injury which requires emergency treatment. The emergency transportation service will determine the facility to which my child will be transported.*
Type first and last name above to consent
SCHOOL YEAR - FACILITY CLOSING CALENDAR
- SEPTEMBER 4, 2023 LABOR DAY

- NOVEMBER 7, 2023 ELECTION DAY

- NOVEMBER 23 2023 THANKSGIVING DAY

- NOVEMBER 24 2023 BLACK FRIDAY

- DECEMBER 25 2023 CHRISMAS HOLIDAY

- JANUARY 1, 2024 NEW YEARS HOLIDAY

- JANUARY 15, 2024 MLK DAY

- FEBRUARY 19, 2024 PRESIDENTS DAY

- MARCH 29, 2024 GOOD FRIDAY

- MAY 27, 2024 MEMORIAL DAY

- JUNE 19, 2024 JUNETEENTH DAY

Tuition Payments are due during facility closures and/or in your child's absence throughout the school year.

**THIS INCLUDES THANKSGIVING/WINTER/SPRING BREAKS
TUITION /BILLING POLICIES

Please be sure to review in its entirety
This form, after being completed and signed by the parent/guardian, must be reviewed for completeness and signed by a Program Administrator prior to the child receiving services. *
Type first and last name above to consent
Sign Document*

My Products

Non-Refundable Administrative Processing Fee

$100.00 # of children
Item subtotal:$0.00

Enter coupon

Total

$0.00

Date Signed*

MonthDayYear
Contact Info
Email: gtalathletics@gmail.com

Payment Methods

Debit or Credit Card

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

Should be Empty:

Program Enrollment Form

PLEASE NOTE THAT EVERYTHING THAT HAS A RED * NEXT TO IT MUST BE COMPLETED IN ORDER TO COMPLETE THE ENROLLMENT PROCESS.

Child's Information

Parents' Information

Heading

Emergency Contacts/Authorized Pickup

Heading

Medical / Health Information

Additional Medication

SCHOOL YEAR - FACILITY CLOSING CALENDAR

TUITION /BILLING POLICIES