Enrollment Form – Acton Academy Rexburg

Hero Enrollment Form

Please complete one for each learner separately. There is a save button at the bottom of the page if you need to save and continue later.

Enrollment Form

Hero's Information

Hero's First Name

Hero's Last Name

Hero's Birthday

Hero's Profile Image for Journey Tracker (please crop before uploading)

Choose photo

Parent Information

Primary Contact

First Name

Last Name

Phone/Mobile

Parent Email

Parent Information

Aditional Contact

First Name

Last Name

Phone/Mobile

Parent Email

Emergency Contact

First Name

Last Name

Phone/Mobile

Health Information

Does your child have any allergies or physical limitaitons that the Acton guides should be aware of?

Is your child up to date on immunizations? (Ages 5+ and only required if not enrolled in a homeschool programs like Tech-Trep)

Yes

Please upload your child's Immunization Record or valid waiver

Choose File

Are you using Tech-Trep, Overture, Home ED 360 (preferred), or Harmony for this learner?

Yes

Yes, not yet enrolled

Acknowledgements

I, the undersigned, hereby acknowledge and agree to the terms and conditions outlined in this safety waiver for the being a learner at Acton Academy Rexburg ("the Organization"). I understand that the school involves hands-on and physical activities for educational purposes. I acknowledge that these activities carry inherent risks and potential hazards.

Assumption of Risk:

I understand that the school involves activities that may result in cuts, bruises, or other minor injuries. I am aware that while the Organization will take necessary precautions to minimize risks, accidents may still occur.

Emergency Medical Treatment:

In the event of an injury or medical emergency during class, I authorize the Organization's staff to seek and consent to any necessary medical treatment for my child. I understand that the Organization will make reasonable efforts to contact me or the emergency contact listed in such situations.

Supervision and Behavior:

I understand that my child will be under the supervision of qualified instructors throughout class. I acknowledge that I am responsible for ensuring my child's behavior is appropriate and follows the guidelines provided by the Organization.

Photography and Publicity:

I grant permission to the Organization to use photographs or videos of my child taken during class for promotional and educational purposes.

Release of Liability:

In consideration of being allowed to participate in the school, I, on behalf of myself and my child, hereby release, discharge, indemnify, and hold harmless the Organization, its employees, instructors, and volunteers from any and all claims, liabilities, injuries, damages, or expenses arising out of or in connection with my child's participation in the school.

I have carefully read and fully understand the terms of this safety waiver. I agree to its conditions and acknowledge that it is binding upon me and my child during their participation in the school.

I have read and agree to the above acknowledgements

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