School Registration Form

School Registration Form

Complete this form to register at Barrington Hill Academy.
Student Full Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Grade
First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please list anyone with permission to pick up the student
My student will be attending

If student will be attending Mondays, please select classes the student is interested in 1 being they would love the class, 4 being they are not interested in the class. This will help us build their preferred schedules.

Rows	1	2	3	4
Horsemanship 2 (Horsemanship 1 is a pre-requisite)
Barrington Brotherhood
Art
Young Entrepreneur
Independent Studies
Spanish 1

If student will be attending Tuesdays, please select classes the student is interested in 1 being they would love the class, 4 being they are not interested in the class. This will help us build their preferred schedules.

Rows	1	2	3	4
Horsemanship 1
Gardening
Farm to Table
Independent Studies
IEA
Explorations into Equine Careers

If student will be attending Wednesdays, please select classes the student is interested in 1 being they would love the class, 4 being they are not interested in the class. This will help us build their preferred schedules.

Rows	1	2	3	4
Horsemanship 2 (Horsemanship 1 is a pre-requisite)
Life Skills
Girls, Grace and Grit
Purpose to Party
Independent Studies
Horse Powered Math

Please list any relevant Medical Info
Please list any Allergies
Additional Questions, Notes or Special Instructions
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