Annual Student Enrollment Forms

ANNUAL STUDENT ENROLLMENT FORM

Student Information

Enrollment Details

Intended Start Date:

Regular Full-Time Part-Time Specialized Program / Elective Track

Parent / Guardian Information

Emergency & Medical Information

Student currently takes prescription medication at school: Yes No

If yes, list medication(s) and administration instructions:

Consents, Authorizations & Acknowledgments

Emergency Medical Treatment Authorization: In the event of illness or injury when I cannot be reached, I authorize school personnel to obtain emergency medical treatment for my child. I understand that I am responsible for any costs incurred as a result of such treatment.

Media and Photograph Release: I grant the school permission to use photographs, video, or audio recordings of the student for educational, promotional, or informational purposes, subject to school policy.

Grant permission for media use: Yes No

Field Trip & Off-Campus Activities Authorization: I authorize the student to participate in school-sponsored field trips and activities that are supervised by school staff. I understand additional notices will be provided for specific trips that carry heightened risk.

Authorize field trip participation: Yes No

Transportation Consent: I authorize the student to ride school-provided buses or contracted transportation for school activities and regular travel as required by the school.

Transportation consent: Yes No

Tuition, Fees & Payment Authorization

Annual Tuition (if applicable): $

One-time payment Monthly installment plan Per-term billing

Payment method authorization (select applicable): Check Credit/Debit Card ACH / Bank Draft

By authorizing a payment method, I permit the school to initiate debits/charges in accordance with the selected plan and understand that missed or delinquent payments may result in late fees, withholding of records, or suspension of enrollment until obligations are met.

Academic Policies & Records

Attendance, Code of Conduct, and Academic Standards: I acknowledge that I have received, reviewed, or will review the school's attendance requirements, code of conduct, grading practices, and discipline procedures. I understand that failure to comply with these policies may result in sanctions up to and including dismissal.

Authorization to Request and Release Records: I authorize current and prior educational institutions to release transcripts, disciplinary records, health records, and other information required to facilitate enrollment. I understand that the release of records is for legitimate educational purposes only.

Authorize records request: Yes No

Special Considerations / Accommodations

Certification & Agreement

I certify that the information provided on this form is true and accurate to the best of my knowledge. I agree to comply with the school's policies and procedures, and I understand that falsification of information or failure to meet financial or behavioral obligations may result in revocation of enrollment or other disciplinary action. I accept responsibility for timely payment of tuition and fees and authorize the school to take appropriate action in the event of delinquency as described above.

I grant permission for school personnel to provide or obtain routine and emergency medical treatment for the student while under school supervision. This authorization does not obligate the school to provide medical services beyond reasonable first aid and emergency response.

I understand that enrollment is subject to verification of records, receipt of required documentation, and acceptance by the school. This form does not constitute final enrollment until all conditions are satisfied.

Student is 18 years of age or older and may sign for self: Yes No

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