Grow Your Mind Academy Annual Registration Form

Student Registration
Student's Name*

First NameLast Name
Student's Birthday*

MonthDayYear
Date
Student Grade Level*
Allergies/Special Accommodations:

Add a student
Student's Name (2nd Student - If applicable)

First NameLast Name
Student's Birthday (2nd Student - if applicable)

MonthDayYear
Date
Student's Grade Level (2nd Student - if applicable)
Allergies/Special Accommodations:

Add a student
Student's Name (3rd Student - If applicable)

First NameLast Name
Student's Birthday (3rd Student - if applicable)

MonthDayYear
Date
Student's Grade Level (3rd Student - if applicable)
Allergies/Special Accommodations:

Add a student
Student's Name (4th Student - If applicable)

First NameLast Name
Student's Birthday (4th Student - if applicable)

MonthDayYear
Date
Student's Grade Level (4th Student - if applicable)
Allergies/Special Accommodations:
If there are more children that are needed to be registered, please list them here:
(include their first and last name, date of birth, and grade level)
Allergies/Special Accommodations for the additional students:

Parent Opportunities

We love having parents involved! There are a few ways you can engage with our community, whether through mentorship or volunteering. Please let us know if you’re interested.
Parent Mentorship Program - Connect with and support other families by sharing your experiences, tips, and encouragement.

Yes, I am interested in joining the Parent Mentorship ProgramNo, thank you
Volunteering Opportunities - Help make our programs even better by volunteering your time and skills.

Yes, I am interested in volunteeringNo, thank you
Contact Permission - If you are interested in volunteering, may we contact you about upcoming opportunities?

Yes, you may contact meNo, thank you

Grow Your Mind Academy Policies & Agreements

(Please read carefully. You must agree to all items to complete registration.)
Code of Conduct - I understand that Grow Your Mind Academy is a respectful, family-friendly environment. I agree that my student(s) and I will treat instructors, staff, and other students with respect, follow classroom rules, and maintain a positive learning environment.*

I agree to follow the Code of Conduct.
Communication & Technology Policy - I understand that all virtual and in-person communications are monitored for safety. My student(s) will not share personal information, inappropriate content, or contact other members outside approved channels. I will supervise my child as required for their age*

I agree to the Communication & Technology Policy.
Photo & Media Release - I grant permission for Grow Your Mind Academy to photograph or video my child(ren) during classes or events for promotional or educational purposes. I understand that names may or may not be used.*

I agree to the Photo & Media Release.I do NOT give permission
Liability Waiver / Hold Harmless - I understand that participation in Grow Your Mind Academy activities carries inherent risks. I agree to release Grow Your Mind Academy, its instructors, volunteers, and affiliates from any liability for injuries or accidents that may occur during classes or events*

I agree to the Liability Waiver.
Registration & Payment Agreement - I understand that a $30 annual registration fee is required per student. This fee is non-refundable and secures my child’s spot in the homeschool program. I agree to pay this fee in full before the start of classes.*

I agree to the Registration & Payment Policy.
Signature / Digital Consent

Powered by Jotform SignClear
By submitting my registration, I acknowledge that I have read and understand the information provided above, and I agree to abide by the program’s policies and guidelines as outlined by Grow Your Mind Academy.*

I agree
Please verify that you are human*
Todays Date

MonthDayYear
Date
Hour MinutesAM/PM Option
Were you referred to us by a friend? If yes, please share their name below.
Referral bonus is applied after registration is completed and registration fees are paid. Both families will receive a $5 tuition credit once enrollment is confirmed.
Should be Empty:

Grow Your Mind Academy Annual Registration Form

Household Information

Student Registration

Add a student

Add a student

Add a student

Parent Opportunities

Grow Your Mind Academy Policies & Agreements