2019-2020 Environmental Science, Psychology, Film as Literature, and Registration

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2019/2020 High School Registration Form

Student's first name *

Student's last name *

Student's birthday *

YYYY

Parent(s) first and last name(s) *

Student's grade *

9th

10th

11th

12th

Other:

Mailing Address *

Mother's phone number

Email address

Father's phone number

Email address

Home Address

Enrollment

Space is limited. You will receive an email confirmation of your student's acceptance into class or placement on the wait list.

In the event that classes meet maximum enrollment your student will be placed on a waiting list.

Fees include the building use and most curriculum, student may be required to buy specific literature, or borrow from the library.

Enrollment: *

Environmental Science B (Life Science Elective) SPRING. $405/semester

Film as Literature (Senior English Elective) SPRING. $405/semester

Psychology (General Elective) SPRING. $405/semester

Required

Please read and check all the following boxes *

I will allocate funds for classes in OLS. I agree to pay directly for any class that is not paid for directly by my child's school/ program.

I understand that I am enrolling my student in a core class that meets once weekly for two hours and my student will have assignments to be completed at home during the week. Most students can complete required assignments in 4-5 hours weekly.

I agree to speak directly to the instructor if I have any questions or concerns at any point during the school year.

I understand that attendance is important and my student will be allowed 2 excused absences each semester for unplanned illnesses/emergencies. Any other absences may incur a cost of $40/hour for instructor to prepare classwork that was missed. (1 hour minimum). Please give at least 1 week notice for any prearranged absences.

I understand that students will be expected to leave campus during lunch from 1-1:30 PM, unless I or my student make arrangements with instructors who remain in the building during lunch time.

I agree that my student will arrive on time to class and that if tardies occur more than twice I will be notified and will make arrangements to ensure my students timely arrival in the future.

If my student has an IEP or 504, I will provide Sandra McMahon with a list of needed accommodations.

I understand that it is my responsibility to routinely monitor my student's progress through the online grading platform that Mrs. McMahon provides.

Required

Billing *

Please bill my charter, alternative or correspondence school

I prefer to self pay, please email me an invoice.

Other:

Which charter or correspondence program are you with

FPCS

Frontier

PAIDEIA Cooperative School

IDEA

Cyberlynx

FOCUS

Deanli Peak

Raven

Other:

Clear selection

Who is your sponsor, contact, or advisory teacher?

Media Release

I, the legal parent/guardian of the minor listed above, give Sandra McMahon permission to use audio/video footage and photographic images that include my student and/or my student's work. Media may be used for work samples, publications (such as Facebook, flyers, posters, website, slide shows, etc.) Student’s names will not be listed on any images other than work samples supplied to families and/or sponsor teachers.

I agree to the media release.

Required

Special Concerns

Please list any medical or other needs that the instructor should be aware of. (allergies, asthma, learning challenges, etc.)

Emergency Contact

Please list a name and phone number of someone other than a parent that we can contact in the event of an emergency in which we cannot reach you.

First and Last name and phone number *

Permission *

I give my permission to my student to fully participate in all classes that they are registered for (excluding anything listed in "special concerns", above.)

Release of Liability *

I understand that although the students will be supervised by McMahon Consulting & Tutoring and Sandra McMahon as well as Staff and/or volunteers, I do assume the risk in my student’s participation in classes.

The information provided in this form is true and accurate. I agree to the permission and release of liability above. Please sign by typing your full name: *

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