Seashore Academy Application Form
Thank you for your interest in Seashore Academy! Your application will be complete when we receive the
1) Signed application form
2) Signed release & financial agreement form
3) Application fee (does not apply to Camp or After School Program).
Email address *
Which program interests you?
Home School Hybrid M/W
Home School Hybrid T/Th
Homeschool Hybrid Friday
Mandarin Immersion Elementary
Camp
After School Program
Child 1
Child 2
Child 3
Child 4
Additional Children
What grades are your child(ren) in?
Your child may register for classes outside of their grade level. However, we enroll based on age-based grade level.
Tk
K
1
2
3
4
5
6
7
8
Child 1
Child 2
Child 3
Child 4
Additional Children
Row 3
Please specify the full name and gender of each child:
Your answer
If you're interested in customized days, please specify here
Your answer
Contact Information
Name of Primary Parent *
Your answer
Email of Primary Parent
Your answer
Cell Phone of Primary Parent
Your answer
Name of Second Parent
Your answer
Email of Second Parent
Your answer
Phone of Second Parent
Your answer
Emergency Contact Name & Relationship to Student *
Your answer
Emergency Contact Phone
Your answer
By this electronic signature below, I agree to pay the non-refundable registration fee of $75.00 (does not apply to the After-School or Camp Programs). *
Your answer
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