Young Legacy Learning Academy Boys Enrichment Art Program Registration

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4740 N. Henry Blvd, Stockbridge, GA 30281 678-360-1868

Email *

Student Name: *

Student Age: *

Student Grade: *

Name of School *

Address: *

Phone Number:

Email:

Mother/Guardian Full Name:

Father/Guardian Full Name:

Which way of communication do you prefer?

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Both

Tell us about your child. Please include information which would be helpful to the staff in understanding and caring for your child.

Is your child able to participate in a classroom setting with 17 or more students without special accommodations?

Yes

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If the answer to the above question is "NO", please specify what additional accommodations your child would require during the Afterschool Program.

Weekly tuition is $65 per week per student. If payment is not received on Friday, a $10.00 late fee will be charged to the weekly fee. Students may be dismissed from the Enrichment Program for non-payment of weekly tuition. (LET US KNOW IF YOU NEED TO HAVE A PAYMENT PLAN). Weekly tuition can be paid by money order, Cashapp, Venmo, or PayPal. Please visit our website to make payments www.youngdreamersint.org. Please be aware that participation on a drop-in basis is not available.
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There is a one-time registration fee of $35.00 that is due upon approved registration in the program and is non-refundable. This is a yearly fee per family. *
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I acknowledge I read the above statement regarding the yearly registration fee.

Required

It is the responsibility of the parent to complete all forms accurately and to maintain records as changes in phone numbers, medical history, guardianship or other pertinent information occur. Parents should provide their child with a signed and dated note addressed to the Afterschool Coordinator if a change in the daily transportation will be made since verbal requests cannot be honored. A handwritten note needs to be sent with your child or email the coordinator.
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I acknowledge I have read the above statement regarding accuracy of records.

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