Spanish Add-On | M.A.K.E. Greatness Academy

Registration for: *

1st - 4th Spanish - Thursdays from 2:30 - 3:15pm - $45/month

Campus: *

Student and Parent Information

Student's Name *

First

Last

Birthday *

Student's Current Age *

Student's Registration Grade Level *

How did you hear about us?

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.

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

1st – 4th Spanish Add-On

Student and Parent Information

Medical and Emergency Information

Approved Guardians for Checkout