Scholastic Power's Registration Form
Thank you for registering for our quality education services. We are excited to work with you and your student!

For more information:
-Visit our website at www.scholasticpower.com 

Follow us on social media:
K-12gr Scholastic Students @scholasticpowerllc
Babies, Toddlers & Preschoolers @littlescholarsed_broward

Email us at scholasticpowerllc@gmail.com 
Call us today at (954) 865-7604

*Check out our new classroom and aftercare program at the Motherhood Village in Coral Springs, Fl!* 

Upon review of your registration form, a member of our team will contact you! 
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Email *
Parent Full Name *
Parent Phone Number *
Student Full Name *
Student Birthday *
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Home Address 
If homeschooled, what is your student's registration date? 
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How did you hear about us?  *
Required
Age/ Grade Level *
Check off all that may apply to your student:
Check off all of the services that you're interested in: *
Required
Please provide any additional information on the type of service that you'd like for your student to receive.
What is your availability to receive services? Check off the days, times & locations to receive services.
Online
In student's home
In local library
At the Motherhood Village cafe
In another agreed upon location
8-9am
9-10am
10-11am
11-12pm
12-1pm
1-2pm
2-3pm
3-4pm
4-5pm
5-6pm
6-7pm
7-8pm
8-9pm
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Summer Break
Spring Break
Winter Break
Holidays/ No School days off
Please provide any additional information about your schedule & availability to receive the services you're interested in. Include details about specific location.  *
Please list any student allergies or medical concerns. *
Do you have any pets in your home? If so, specify animal and size. *
Permission for client's pictures or videos of sessions to be used for public advertising purposes on print and/or online publications with or without name, such as on our company website, social media, flyers, presentations, multimedia and other advertising forms. No royalty, fee or compensations will become payable to the client by any reason of such use. *
I understand that it is important to attend scheduled services on time. If I am running late, I will notify Scholastic Power at 954-865-7604 as soon as possible. After 15 minutes have passed, if there is a no-show without notification, the scheduled service payment is still due. To reschedule without loss of payment, contact Scholastic Power by the morning of the scheduled services. *
Payments are due prior to receiving services. If using the Step Up scholarship, be sure to enter your sessions in advance. There is a 3-day grace period after the agreed upon date for payment. After three days have passed, beginning on the fourth day, a late fee of $20 per day will incur. *
Payments are accepted via Zelle to scholasticpowerllc@gmail.com.  There is a 3% processing fee to use your bank card online at https://pay.scholasticpower.com.

Please click your preferred form of payment below:
 *
Required
Scan the QR Code for Quick Payment
Health & Wellness Policy

At Scholastic Power, we prioritize the health and well-being of our students, providers, and families. We understand that illness can arise unexpectedly, and we appreciate your mindfulness in preventing the spread of sickness.

For in-person services, we leave the decision to proceed with a session up to the provider and the parent. If either the student or provider is feeling unwell, we highly recommend rescheduling or canceling by the morning of the scheduled session. Alternatively, sessions may continue online or in person with agreed-upon health precautions, such as wearing masks, using hand sanitizer, or maintaining physical distance.

To accommodate different comfort levels, we ask parents to indicate below their preferences regarding in-person sessions when illness is present. This allows us to match students with providers who align with their health and safety expectations.

Thank you for your cooperation in keeping our learning environment safe and respectful for everyone!

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Click to read the Educational Services Agreement in another window. Be sure to come back to complete your application.

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Questions or comments? *
What is the best way to contact you? *
Required
If you would like us to follow you on Instagram, or tag you in any photos or events, please provide your IG @ handle name. *
Please list any emergency contacts: Names and Phone Numbers *
Thank you for filling out this registration form. A member from our team will be in contact with you soon. Please type your full name. *
Today's Date *
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Check out our website at WWW.SCHOLASTICPOWER.COM
Follow us on Instagram & Facebook @scholasticpowerllc @littlescholarsed_broward
Call (954) 865-7604 for more information! Thank you!
A copy of your responses will be emailed to the address you provided.
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