Next Generation Prep Academy  
We welcome all 8th - 12th graders to join our Next Generation Prep Academy. Please complete the short form and our program assistance will contact you shortly. If you have any questions or currents please feel free to contact us at 706.534.1145 or 
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What is your name?
What is your birthday?
What school do you currently attend?
What grade are you currently in?
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What is your email address?
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What is your availability during the week?
What is your gender?
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What is your parent or guardian name?
What is your address?
 I authorize Cultivating Lifetime of Legacy, Inc. to obtain copies of my child’s report cards, transcripts, and test scores to provide him/her/myself with academic advising. I hereby give permission for images of child/self, captured during sessions, services, & events through video, photo, etc., to be used solely for the purposes of CLL, Inc. promotional materials (e.g., brochures, newsletter) and waive any rights of compensation or ownership thereto. I give my child/children full permission to participate in Cultivating a Lifetime of Legacy, Inc. programs. I understand that if any accident occurs to my child/children while participating, I will take full responsibility for all medical fees. My child/children can participate in all activities (field trip, classes, and other enrichment activities). Cultivating a Lifetime of Legacy, Inc. will exercise the utmost safety, caution, and care of your child/children while participating in our programs. *
A copy of your responses will be emailed to the address you provided.
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