Discovery HS - Community School Summer Health and PE Registration Form
Email address *
CLASS INFORMATION
CLASS DATES: May 29- June 1, June 4-7, June 11-14, June 18-19, 2018
*** Make-Up Dates: June 20-21
(Dates could change due to school make-up dates)
HOW TO REGISTER
ONLINE
Register online and pay by credit card on MYPAYMENTSPLUS.COM or
IN PERSON
Complete all information below and bring proof of payment
(Check or MYPAYMENTSPLUS.COM receipt ONLY - NO CASH will be accepted)
PAYMENTS
CREDIT CARD - MYPAYMENTSPLUS.COM
CHECKS - Make checks payable to: DISCOVERY HS COMMUNITY SCHOOL
(Returned Checks subject to a $35.00 Processing Fee)
CASH - NO CASH payments will be accepted
CLASSES
CLASS CHOICES *
CLASS TIMES PREFERRED *
Selections may be switched by registrar.
ENROLLMENT INFORMATION
Please Complete the Following
Student's School ID Number *
Student's Last Name *
Student's First Name *
Students Date of Birth *
MM
/
DD
/
YYYY
What High School will the student be attending in the Fall? *
Select Student's grade level for the Fall (2018-2019) *
Required
Street Address *
City *
Zip Code *
PARENT OR LEGAL GUARDIAN INFORMATION
Name of Father or Legal Guardian *
Father or Legal Guardian's Phone Number *
If listing more than one number, please indicate type. (Example Cell: 404-555-1234; Work 404-555-9876)
Name of Mother or Legal Guardian *
Mother or Legal Guardian's Phone Number *
If listing more than one number, please indicate type. (Example Cell: 404-555-1234; Work 404-555-9876)
Home Phone Number *
EMERGENCY INFORMATION
Emergency Contact's Name *
In the event of an emergency, please list the person to whom we need to call.
Emergency Contact's Phone Number *
SUMMER CLASS POLICIES & CONTRACT
1. I understand that no more than three (3) days absence from each class is allowed. Three tardies are equal to one absence. Anything up to 29 minutes late will be a tardy; after 30 minutes it will be counted as an absence. I understand that I will be withdrawn upon the fourth absence.

2. I understand that withdrawal from class will occur for nonattendance or disciplinary action. It is my responsibility to notify my parents if I am absent or withdrawn from class.

3. I must provide my own transportation to and from all classes.

4. I accept the responsibility for following all rules and requirements as stated in the Gwinnett County Public Schools student handbook. I expect the procedures that are listed therein to be enforced by the teachers and administrators. I agree to abide by the rules and regulations outlined.

5. I understand the following refund policy:
• Nonrefundable fee of $25 assessed for withdrawal
less than a week before class begins.
• No refund after class begins.

6. If I receive special services at my home school, I understand that it is my responsibility to provide a copy of my IEP or 504 plan to the Community School Director.

7. I agree to pay for any lost textbook.

8. Credit will be given only for student fulfilling academic and attendance requirements.

SIGNATURES
Parent's or Legal Guardian's Signature *
By entering my name below, I certify that I am the parent or legal guardian of the student listed above. We have reviewed the provisions of the Entrance, Withdrawal and Behavioral Contract and agree to its’ terms. We also acknowledge that our students account must be PAID IN FULL by May 18, 2017.
Student's Signature *
By entering my name below, I certify that I am the student listed above. I have reviewed the provisions of the Entrance, Withdrawal and Behavioral Contract and agree to its’ terms. I also acknowledge that our students account must be PAID IN FULL by May 18, 2017.
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