Enrollment Form

Student Details:

Gender
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Race/Origin (check all that apply)
Ethnicity: Is the student of Hispanic or Latino origin?

* Racial and ethnic categories conform to Department of Education required reporting specifications.

Family Information:

Parent/Legal Guardian 1:

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If living separately, please provide your mailing address:

Parent/Legal Guardian 2:

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If living separately, please provide your mailing address:

Signatures:

Parent(s)/Guardian(s):

I(We) affirm that all information presented in conjunction with the application process is true and complete. I(We) understand Young Champions relies on the material accuracy of all information provided in conjunction with the application process, and any material inaccuracy or change in circumstances constitutes grounds for Young Champions to revoke admission or dismiss an enrolled student.

I(We) understand that submission of this form is not a guarantee of admission. Young Champions will review this information and will get back to me(us) to confirm the availability and further paperwork about agreement, policies and payments for us to review and sign before my(our) child is formally registered.