Geometry or Financial Literacy 2019-2020
2019-2020
Email address *
Student first name *
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Student last name *
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Student's birthday *
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Student's grade *
Parent(s) first and last name(s) *
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Mailing Address *
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Mother's phone number
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Mother's Email address
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Father's phone number
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Father's Email address
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Home Address
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Space is limited. You will receive an email confirmation of your student's acceptance into class or placement on the wait list.

In the event that classes meet maximum enrollment your student will be placed on a waiting list.

Fees include the building use, most curriculum and some supplies. Students will need basic supplies & some project supplies for all classes.
Enrollment: *
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Please read and check all the following boxes *
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Billing *
Which charter or correspondence program are you with?
Who is your sponsor or contact teacher? *
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Media Release
I, the legal parent/guardian of the minor listed above, give Ema McMahon permission to use audio/video footage and photographic images that include my student and/or my student's work. Media may be used for work samples, AK Homeschool Classes Ema McMahon's publications (such as Facebook, flyers, posters, website, slide shows, etc.) Student’s names will not be listed on any images other than work samples supplied to families and/or sponsor teachers.
Special Concerns
Please list any medical or other needs that the instructor should be aware of. (allergies, asthma, learning challenges, etc.)
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Emergency Contact
Please list a name and phone number of someone that we can contact in the event of an emergency in which we cannot reach you.
First and Last name and phone number *
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Permission
I give my permission to my student to fully participate in all classes that they are registered for (excluding anything listed in "special concerns", above.)
Release of Liability
I understand that although the students will be supervised by Ema McMahon's Staff and/or volunteers, I do assume the risk in my student’s participation in classes

I acknowledge that I will not seek to have the Ema McMahon or any other staff or helpers held liable in the event that any accident, injury, loss of property or any other circumstance or incident occurs during or as a result of my son’s/daughter’s participation classes. This release of liability includes accident, injury, loss, or damages to the student, as well as, to other individuals or property which may result from the student’s participation in the event. I hereby release and agree to hold harmless Ema McMahon its officials, agents and employees and volunteers, from any claims arising out of my son’s/daughter’s participation in the event(s).
I have read and understand and accept all of the statements recited above and accept full responsibility as described.

The information provided in this form is true and accurate. I agree to the permission and release of liability above. Please sign by typing your full name: *
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A copy of your responses will be emailed to the address you provided.
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