Achieve Miami Fall Virtual Programming Registration (Elementary Students)
Achieve Miami is offering a variety of virtual programming in the Fall including piano, percussion, computers, dance, STEAM and more. We are especially excited to continue Achieve Saturdays where our elementary Little Buddies will partner with a high school Big Buddy to read, write, learn, and play. Buddies come together to achieve!

Learn more at: https://achievemiami.org/elementary/

Please complete one form per child.

Follow @AchieveMiami on Instagram for updates and information.
Student Name (First & Last) *
Student Address *
(Number, Street, Unit, City, State, Zip Code)
Student Grade Level *
Student MDCPS Email
Student ID number
School *
If your student's school is not listed above, please share it here:
COURSE SIGN-UP
Please select all of the programs you would like to register your child for. *
Captionless Image
Yes, please sign my student up!
No, not interested
Percussion Course
Piano Course
Achieve Adventure Hour
Achieve Saturdays
STUDENT INFORMATION
Student Birthday *
MM
/
DD
/
YYYY
Student Race *
Please select all that apply.
Required
Is your student of Hispanic, Latinx, or of Spanish origin? *
PARENT/GUARDIAN INFORMATION
Parent/Guardian Name *
Parent/Guardian Phone Number 1: *
Parent/Guardian Phone Number 2:
Parent/Guardian Email: *
Parent/Guardian Instagram handle(s):
Follow @AchieveMiami
Participant Waiver, Release of Liability, and Media Consent: *
Please read Achieve Miami's Parent/Guardian Consent Form ("Consent Form"), available at: https://bit.ly/ElementaryRelease. Among other things, this includes a media consent and liability waiver. After reviewing, please indicate below that you have read, understood, and agree to the terms in the Consent Form:
INTERNET & DEVICE
Does your student have their own device (laptop, tablet, etc.) that they can use to access virtual classes? *
If you answered yes above, what kind of device does your student have?
Laptop, Chromebook, Tablet, Phone, Etc.
Do you have reliable internet access in your home? *
How do you access the internet? *
ANYTHING ELSE?
Is there anything else you would like to share with us?
Submit
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