CGR Learning Lab Enrollment Form 2020-21
Learning Center/Education Consulting Enrollment Form
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Email *
Language *
Student Information - Name *
Student Information - Birthday *
Student Information - Sex *
Student Information - School *
Student Information - Grade (2020-21) *
Parent Contact 1 - Name *
Parent Contact 1 - Cell Phone *
Parent Contact 1 - Cell Phone Provider *
Parent Contact 1 - Work Phone *
Parent Contact 1 - Home Address *
Parent Contact 1 - Work Address *
COVID-19 Exposure - Do you agree to answer daily questions concerning COVID-19 exposure, based on you, your child and all household members? *
COVID-19 Exposure - Do you agree to provide daily temperature readings, prior to your student(s) attending the center? *
COVID-19 Exposure - Do you agree to immediately notify CGR Learning Center concerning any exposure to COVID-19 as it relates to you, your student(s) and all household members? *
Have you read and agreed to all CGR Learning Center program rules - *
I acknowledge that enrollment is not complete and my child can NOT attend CGR Learning Center until all required MSDE/Office of Childcare forms are returned to CGR: *
I understand that my child must have a NEGATIVE Covid-19 test from a 3rd party facility, taken on/no later than Sep. 5, 2021: * *
I acknowledge that enrollment requires a deposit of $550 per child and recurring payments due bi-weekly through June 14, 2022. Payments can be made via Zelle ( or check (CGR Academy, 10274 Lake Arbor Way #205, Bowie, MD 20721). Credit cards are not accepted for this program. *
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Please provide your requested Learning Pod schedule.  Please note, these time slots are assigned on a first come/first served basis to ensure 6 Feet of separation at drop off for all families. *
I acknowledge that REFUNDS AND CANCELLATIONS are NOT PERMITTED once enrollment has been confirmed.  Withdrawal requires 30 days notice. *
A copy of your responses will be emailed to the address you provided.
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