Child's Name
*
First Name
Last Name
Social Security Number
*
Date of Birth
*
MM
DD
YYYY
Sex of Child
*
Father's Name
*
First Name
Last Name
Father's Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Father's Home Phone
*
(###)
###
####
Father's Work Phone
*
(###)
###
####
Father's Cell Phone
*
(###)
###
####
Father's Occupation
Father's Occupation Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Father's Email
*
Mother's Name
*
First Name
Last Name
Mother's Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Mother's Home Phone
*
(###)
###
####
Mother's Work Phone
*
(###)
###
####
Mother's Cell Phone
*
(###)
###
####
Mother's Occupation
Mother's Occupation Address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Mother's Email
*
Emergency Contact Name
*
First Name
Last Name
Relation to Child
*
Emergency Contact Phone Number
*
(###)
###
####
Emergency Contact #2
First Name
Last Name
Relation to Child
Emergency Contact Phone Number
(###)
###
####
Emergency Contact #3
First Name
Last Name
Relation to Child
Emergency Contact Number
(###)
###
####
Previous School Name
*
Grades Attended
*
Check All that Apply
Previous School #2
Grades Attended
Check All that Apply
Previous School #3
Grades Attended
Please tell us why you are sending your child to a new school?
*
How does your child feel about going to school
*
If Yes, please explain below.
If Yes, please explain below.
If Yes, please explain below.
Has your child ever been enrolled or recommended for any of the following special classes?
*
If Yes, please explain below.
If Yes, please explain below.
Are there any unusual factors in your child's life and/or home situation that may affect his/her performance in school? If issue is of a sensitive nature which you would prefer to discuss in person, please indicate.
*
Yes
No
If Yes, please explain below.
If Yes, please explain below.
If Yes, please explain below.
We understand and consent the Academy's philosophy of teaching the Bible, and sharing Jesus with all students as a part of everyday school activities.
*
We agree to support the standards of the school in every area of philosophy, policies and rules to include: spiritual, academic, behavioral, dress, moral, and disciplinary issues.
*
We agree to attend at least two services at Calvary Chapel of San Antonio per month. Eligible services include Sunday morning, Wednesday evening and Friday evening
*
We agree to help assume responsibility for our child's education through supervising homework and reviewing/signing daily folders.
*
We agree to allow Academy personnel to administer corporal punishment (spanking) to our child when necessary. Parents will be contacted when this occurs.
*
We understand that if our child continues a pattern of willful disobedience he/she will be disenrolled from Calvary Chapel Christian Academy.
*
In the event our child becomes ill or injured while under school supervision, we give consent for the school authorities to take the following steps:
*
1) Contact a Parent of the child and follow his/her instructions.
2) Contact the child's physician and follow his/her instructions in the event neither parent can be reached.
3) Use their own discretion to contact a properly licensed healthcare provider and follow his/her instructions if the child's physician cannot be reached.
If, in the opinion of a properly licensed healthcare provider, our child needs medical or surgical services which require our consent before supplied and we cannot be reached, we hereby authorize, appoint, and empower the school principal, or his designee, to furnish such written or oral authorization as may be required on our behalf. Further, we release the principal, his designee, Calvary Chapel Christian Academy, and Calvary Chapel of San Antonio from any liability that might arise from the giving of such authorization..
*
We understand that Calvary Chapel Christian Academy reserves the right to refuse any application or dismiss any child at any time for unacceptable work or conduct or any other reason it deems necessary in accordance with its policies and procedures. Failure of the parent to abide by the terms of this contract will result in student dismissal from the Academy.
*
Date
*
Provide the date that this agreement was signed
MM
DD
YYYY
Date
Provide the date that this agreement was signed
MM
DD
YYYY
Thank you for submitting your application for academy enrollment.
Mathew Marquez, Principal
Calvary Chapel Christian Academy
