Application Form for BK Academy
Email address *
Child Name *
Your answer
Child Birthday *
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Child Sex *
Child Address *
Your answer
Mother's Name *
Your answer
Mother's Cell Number *
Your answer
Mother's email Address
Your answer
Father's Name *
Your answer
Father's Cell Number *
Your answer
Father's email address
Your answer
Grade Level Your Child Is Applying for *
Please submit an application packet for BK Academy, which includes; (a) An application for admission, (b) $100 non refundable application fee, (c) $500 non refundable IQ test fee if test is to be done at BK Academy ($600 if not applying for BK), (d) An IQ test report if the test is done outside BK Academy, and (e) A copy of transcript from a current school for 1-5th grade applicants. Please Note that preschool is 4 hours daily (4 days or 5 days a week) and Kindergarten or upper grade is 6 hours daily 5 days a week. * *
Participant Release of Liability during the Visit and/or Testing: I authorize BK Academy to send my child to the hospital or doctor in the event of an emergency. I also authorize the treating physician all medical emergency procedures necessary on my child. I understand and agree to be fully responsible to be fully responsible for the payment of the services rendered. As the person responsible for the above named child, I hold BK Academy not liable for any physical injury, loss, damage, or other consequences that may arise or result directly from any activity or class in which my child may participate. I hereby assume all risk of liability for injury, loss, damage or other consequences. I understand that I am responsible to have accident and medical insurance overages for my child or children. *
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You Name as a Signature *
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BK Academy does not discriminate on the basis of race, ethnicity, national origin, religion, or family structure in admissions. *
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