Enrichment Registration | M.A.K.E. Greatness Academy

Registration for: *

Enrichment Wednesday - Fall 2022 - Spring 2023 - McKinney Campus

Student and Parent Information

Student's Name *

First

Last

Birthday *

Student's Current Age *

Student's Current Grade Level *

How did you hear about us?

Child's Educational Background *

Please attach a copy of your child's 504 plan or IEP if applicable.

Click or drag a file to this area to upload.

Parent/Guardian Name *

First

Last

Parent/Guardian Phone *

Parent/Guardian Email *

Home Address

Address Line 1

Address Line 2

City

State

Zip Code

Policies & Procedures *

My child and I understand and agree to abide by the school's Policies & Procedures.

Medical and Emergency Information

Emergency Contact 1 (other than parent/guardian listed above) *

First

Last

Emergency Contact 1 Phone Number *

Emergency Contact 1 relationship to student *

Emergency Contact 2 (other than parent/guardian listed above) *

First

Last

Emergency Contact 2 Phone Number

Emergency Contact 2 relationship to student

Medical Waiver *

I agree to the terms & conditions of the Medical Waiver.

Insurance Information

Company

Policy Number

Doctor Name

Doctor Phone

Preferred Hospital

Does your child have any allergies or medical conditions? Please explain:

Approved Guardians for Checkout

Check Out Guardian 1 *

First

Last

Phone 1 *

Check Out Guardian 2

First

Last

Phone 2

Academy Commitments

Payment Agreement *

I agree to the Payment Agreement listed below:

-An annual Student Registration fee of $50 is due at the time of registering and applies for all classes for the entire school year. 2-Day Academy families that have already paid their registration fee are exempt from the enrichment registration fee.
-This is a semester long commitment.
- Supply fees will cover provided curriculum. They are based on grade level and will be invoiced to you by email.
- Tuition is due on the 20th of each month starting in August, ending in November.
- A late payment of $25 will be added to any payments over 3 days late.

Media Release Agreement *

I agree to the Media Release Agreement listed below:

-I grant permission to M.A.K.E. Greatness Academy, hereinafter known as the “Media”, to use my image (photographs and/or video) for use in Media publications including:
Videos, Emails, Marketing Brochures, Newsletters, General Publications, Social Media, Websites.
-I hereby waive any right to inspect or approve the finished photographs or electronic matter that may be used in conjunction with them now or in the future, whether that use
is known to me or unknown, and I waive any right to royalties or other compensation
arising from or related to the use of the image.
-I have read this release and I fully understand the contents, meaning and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions in writing prior to agreeing, and I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.

I consent to my information being published in our Private Parent Portal. *

Yes
No

9am - 11am Class Choice:

12pm - 2pm Class Choice:

K-1st - Mathematicians/Puzzlers
1st-12th - Theatre Production*
1st-3rd - Calling All Mad Scientists (hypothesis, test, repeat)
4th-6th - Painting the Classics
7th-12th – Chess
5th - 8th - STEMsational!

*Title and Performance Date TBD - will be based on classic literature and/or fairy tales etc. Auditions for specific roles will take place during the 2nd class. There will be a mandatory 'tech week' the Tuesday-Friday prior to our Saturday performance, typically 5pm - 9pm.

1st - 4th Thursday Spanish 2:30-3:15pm

1st - 4th Thursday Spanish 2:30-3:15pm

Half Day Students - Will your child stay late/come early for lunch? *

Yes
No

Family Registration Fee

Total

$ 0.00

Square *

Card

Name on Card

Enrichment Day Registration

Student and Parent Information

Medical and Emergency Information

Insurance Information

Approved Guardians for Checkout

Academy Commitments