Nsoromma School's Triple Threat ACT Test Prep Registration
Email address
Student Name
Your answer
Grade
School
Your answer
Parent Name
Your answer
Parent Phone
Your answer
Parent email that is checked regularly
Your answer
Student email
Your answer
Previous ACT or SAT scores (Date taken; Total and subtest scores)
Your answer
Challenges: Has the student ever had learning or behavioral challenges or issues that required tutoring, counseling, special classes, 504 Plans, etc.? If yes, please describe briefly.
Your answer
POLICIES AND PERMISSIONS
I understand that cancellations received in writing eight or more days prior to the first class will receive a refund of money paid minus a $35 cancellation fee. There are no cancellations for requests received less than eight days prior to the first class. However, if the cancellation request is received prior to the first day of class, the amount paid can be applied to another test prep course offered within 12 months. I understand that there are no refunds or future applications of fees on or after the first day of class. There are no refunds for missed classes and no make-up classes offered. I certify that all of the information in this application is true and complete to the best of my knowledge and that I have not intentionally falsified or misrepresented any information.
Your answer
I hereby grant permission for me/my child to participate in the Nsoromma School, Inc.’s Triple Threat Test Prep Program. I hereby agree to hold harmless and release Nsoromma, its officers, directors, employees, students and representatives (“Releasees”) from any claims of damage arising from my child’s participation in the program. I have signed this release with full recognition and appreciation of the risks of such activities, including risks associated with transportation to and from Nsoromma School, Inc.
Your answer
I agree that Nsoromma School, Inc. personnel are granted permission to authorize emergency medical treatment if necessary and that such action by persons shall be subject to the terms of this release. I understand that Releasees assume no responsibility for any injury or damage that might arise out of or in connection with such emergency medical treatment. I further agree that this consent and release shall be construed in accordance with the laws of the State of Georgia. If any term or provision of this consent and release shall be held illegal unenforceable or in conflict with any law governing this consent and release, the validity of the remaining portions shall not be affected.
Your answer
MEDIA RELEASE: I grant my permission to The Nsoromma School, Inc., its representatives, employees or to those whom permission is granted by The Nsoromma School, to make motion or still pictures and television and video tapes including website uploads of these in which I/my child may appear. I understand that no payment whatsoever will be made to either my child or myself for his/her appearance in these films, photographs or tapes. It is further understood that these films, photographs and/or tapes are used solely for educational and/or promotional purposes. This consent shall be effective for five years from the date signed or until I withdraw my consent in writing. As evidenced by my (typed) signature below, I have carefully read and fully understand the terms and conditions of this permission form.
Your answer
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms