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Registration is currently still open.
Thank you for your interest in enrolling your child in the High Altitude Club’s Homeschool Enrichment Program. To ensure a safe and productive environment for all participants, we ask that you complete this form honestly and thoroughly. Your cooperation helps us create a thriving program for every student.
Please submit a separate form for each child, as each person is considered an individual participant. Even if some information overlaps, it’s important that we have a dedicated form for every child.
Student Information
Parent/Guardian's Information
Medical, Behavioral and Academic History
Please check all that apply to the student:
My child has never been expelled, involved in a fight, engaged in bullying or displayed any other behavior that may pose a risk to themselves or others.
My child has been expelled
My child has been involved in a physical altercation
My child has a history of bullying behavior
Other
Does your child require any behavioral or academic accommodations? (e.g., IEP, 504 Plan, specific classroom needs):
Yes
No
Does your child have any allergies or medical conditions we should be aware of? (e.g., food allergies, asthma, medications):
Emergency Contact Information
Authorized Pick-Up Individuals
Please list the names and contact information of individuals authorized to pick up your child other than the parent/guardian(s):
Are there any individuals who are NOT authorized to pick up your child?
Character Reference
Please provide at least one reference who can vouch for your child’s character:
Code of Conduct and Program Policies
By completing and submitting this form, you acknowledge and agree to the following:
Submission of this form does not guarantee placement into the High Altitude Club’s Homeschool Enrichment Program.
All information provided is accurate and truthful. Failure to disclose necessary information may result in the denial or dismissal of your child from the program.
Adherence to the High Altitude Club’s code of conduct is mandatory. Violations may lead to dismissal without refund of payment(s).
Thank you for your cooperation!
