Summit Academy Intent to Register Form HSC Conference 2019
Welcome, Summit Academy Families! HSC is delighted to offer Conference 2019 Registration through Summit Academy this year.

HSC Conference 2019 will be August 8-11, 2019 at the DoubleTree by Hilton San Jose.

Please fill out ONE FORM per family, and ONLY include the names of family members whose passes will be paid for with charter school funds. Summit Academy will purchase student and parent passes only; siblings of students who are not current Summit Academy students themselves are not covered by this program.

***Summit will pay for ONE parent pass per student, up to TWO parents. This means if you have one Summit student, Summit will pay for one parent with Summit's funds. You must purchase the second parent's pass out of pocket.***

If you are purchasing some conference passes with charter school funds and some on your own, please contact our Conference Registrar at hscconference.reg@gmail.com for assistance.

You must submit the Summit Academy Intent to Register Form by June 1, 2019.

Please ensure that you have filled out the form completely, and check your arithmetic for accuracy. Missing/incorrect information will delay your order.

Student #1 Name (must be a current Summit Academy student) *
Your answer
Student #1 age group *
Student #2 Name (must be a current Summit Academy student)
Your answer
Student #2 age group
Student #3 Name (must be a current Summit Academy student)
Your answer
Student #3 age group
Student #4 Name (must be a current Summit Academy student)
Your answer
Student #4 age group
Parent #1 Name *
Your answer
Is Parent #1 also ordering a conference pass with Summit Academy funds? ($180/adult) *
Parent #2 Name
Your answer
Is Parent #2 also ordering a conference pass with Summit Academy funds? ($180/adult)
Parent #1 Email *
Please give the best email to use (i.e., one you check regularly).
Your answer
Parent #1 Phone Number *
Your answer
Parent #1 Street Address, State, and ZIP - We need your FULL ADDRESS to process your order. *
Your answer
Your Educational Specialist's name: *
Your answer
Your Educational Specialist's email *
Your answer
I agree that HomeSchool Association of California (HSC) will invoice Summit Academy for $180 for each adult conference pass requested, $180 for each teen conference pass requested, and $150 for each child conference pass requested. There is a one-time $30 processing fee per family which will include one year of HSC membership. These funds will be deducted from my allotted educational funds for the 2018-2019 school year. Conference passes are NOT refundable, and passes purchased with charter school funds are NON-TRANSFERABLE. *
I understand that HSC is NOT RESPONSIBLE for confirming whether I have sufficient charter school funds to pay for my conference passes, and that if my Intent to Register With Charter School Funds is DECLINED by Summit Academy due to lack of funds, my purchase options will be limited to purchasing passes myself at the current prevailing conference pass rate at www.hscconference.com/registration.html. *
I understand that although I am welcome to volunteer at HSC Conference 2019, Work Exchange reimbursement is NOT available to those who purchase conference passes with charter school funds. *
I have read and agree to HSC's Family Event Release, Waiver of Liability and Indemnity Agreement, and Anti-Bullying Policies, located here: http://www.hsc.org/liability-release-form.html *
Total amount to be billed to Summit Academy by HSC, deducted from my student's educational funds: (Please add $180/adult, $180/teen, $130/child PLUS one $30 fee per family) *
Your answer
Special Note for Registration Coordinator or Conference Coordinator
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.