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WE ARE NOW ACCEPTING APPLICATIONS

FOR OUR CHRISTIAN ACADEMY 

2024-2025 SCHOOL YEAR!

Registration / Enrollment Online E-Application

COMPLETE ENROLLMENT APPLICATION

Child's Information: Full Name, Age and Birthdate

Mother / Guardian Name, Address, Phone Number

Mother / Guardian's Email Address:

Father / Guardian's Full Name, Address and Phone Number:

Father's Email Address:

Marital Status: Check One

If divorced are there any custody issues?

If Yes, Explain __________________________________

Food Allergies: Please list any foods or liquids your child is allergic to:

Signing Child In and Out and Emergency Contacts: List names of person 18 and older authorized to pick up your child and call in case of any emergency. Please include address, phone number and relationship.

Signature

Date of Submission

Text

Note: Pay your Registration / Enrollment Fee Here by clicking the Donate Button

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