Student's Name
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First Name
Last Name
Student's Birthday
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MM
DD
YYYY
Age
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Any Allergies?
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Current Grade Level
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School Experience
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None
Daycare
Public School
Private School
Homeschool
Other
Does your child have a 504 and/or IEP?
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How would you like your child to attend school at CHA?
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What is your child's t-shirt size?
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Parent/Guardian Name
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First Name
Last Name
Email
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Phone
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(###)
###
####
Parent/Guardian Name
First Name
Last Name
Email
Phone
(###)
###
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Mailing Address
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Off Season Address
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How do you prefer we communicate with you about scheduling, progress, and updates?
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Zoom/Google Meet
Phone Call
Text
Email
Other
Name
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First Name
Last Name
Email
*
Phone
(###)
###
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Relationship to the Student
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Second Emergency Contact
First Name
Last Name
Email
Phone
*
(###)
###
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Relationship to the Student
We teach all year round. Does that work for your schedule?
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Families may choose to take a summer break. If you plan to return in the fall, a holding fee will be required to reserve your child’s spot. Summer scheduling details will be shared each April.
Our school days range from 2 - 4 hours per day. What time of day works best for you and your family?
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When would you like your new teacher to begin working with your child?
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How long do you anticipate your child will be enrolled?
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We use this information to plan teacher contracts and ensure continuity for your child. If your plans change, please communicate with us as soon as possible.
Do you anticipate remaining enrolled during off-seasons or breaks in your child’s sports/travel schedule?
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Please share any important details about sports training, travel, or other commitments that may affect your child’s availability.
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Does your child have reliable access to a computer and high-speed internet for virtual sessions?
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How would you describe you the temperament and personality of the child enrolling at CHA?
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Describe the personality your child best connects with.
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What are your main goals for your child’s learning with Courtside Homeschool?
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What challenges or learning gaps are you hoping to address?
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Is it ok for your teacher to bring their own lunch into your home?
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Can your teacher bring snacks or treats for your child?
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Do you have any pets in the home?
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Anything else we need to take into consideration?
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Share any details about your child’s learning needs, family schedule, timeline or other important information.
I hereby give permission for my child to participate in all lessons and learning activities affiliated with Courtside Homeschool Academy, LLC, and its teachers and staff. I acknowledge that Courtside Homeschool Academy (CHA) will not assume any responsibility or liability for personal injury or damages caused by accidents or illnesses during instruction, or while under the supervision of a CHA teacher or staff member. In the event that CHA is unable to reach a parent, guardian, or emergency contact, I hereby authorize Courtside Homeschool Academy to obtain and approve medical care for my child in the case of an emergency. As the child's parent or guardian, I assume sole responsibility for any expenses incurred as a result of necessary medical care.
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I hereby give Courtside Homeschool Academy, LLC absolute rights and permission to publish and/or print photographs, videos, and/or names of my child and/or myself taken during instruction or learning activities affiliated with Courtside Homeschool Academy (CHA), including CHA-sponsored events. These may be used for the following purposes: marketing materials, social media posts, website information, and all other publications of CHA. I understand that both my name and my child’s name may be used in connection with these photographs or videos. I agree that all such materials may be used without compensation to my child, me, or our family. I waive all rights to inspect or approve the use of photographs, videos, or names before publication. In the case that I wish for photographs, videos, or names of my child or myself to NOT be used in any way by Courtside Homeschool Academy, I agree to send written notice, signed and dated, stating that request.
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We understand plans change. We will gladly issue a full refund for any cancellation requests received within 14 days of the start of the program.
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