One Day Academy » New Family Registration

You may fill this out on-line, print it off, and bring/mail it in. Or you may pick up a copy at any campus during normal hours of operation.

Parent Contact Info

Check Number:	Home Phone:
Dad's First Name:	Dad's Last Name:
Mom's First Name:	Mom's Last Name:
Dad's Cell:	Mom's Cell:
Dad's Email:	Mom's Email:
Address:
City:	Zip:

Student #1

Name:	Age:
Classes:	Relevant Medical conditions:

Student #2

Name:	Age:
Classes:	Relevant Medical conditions:

Student #3

Name:	Age:
Classes:	Relevant Medical conditions:

Emergency Contacts

Who is another person we can contact in the event of an emergency?

Acceptance

I agree to register with each teacher with whom my child is taking a class.

I agree to pay the $25 per family (good for all campuses) registration fee.
(please make payable to "One Day Academy")

I agree to accept the policies of One Day Academy any time I am on a One Day Academy campus.

I give permission for my child to be photographed in the course of normal classroom activities, and for the picture to be used on the website of One Day Academy.

___________________________________________________________________
Parent Date

Please mail to: Rhonda Hensley, 208 Shale Drive, Jarrell, TX 76537

Office Use

EMG

Certificate Number:

New Family Registration

Parent Page

Academic Support