Homeschool Co-op Registration Form
Parent:
*
First Name
Last Name
Parent Phone Number:
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Contact Email:
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student Name:
*
First Name
Last Name
Student Birth Date:
*
 /
Month
 /
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Student Age:
*
Student Grade:
*
Grade level for 2022-2023 school year
Allergies/Medical Conditions:
List the allergy/condition and any special needs or instructions the co-op director and teachers need to be aware of.
Student Class Selections (listed by hour):
1ST Montessori Learning (ages 3-6)
1ST Lego Club (All ages)
1ST Book Club (MS)
1ST Poetry (MS/HS)
2ND Little Hands Arts & Crafts (ages 4-8)
2ND US History-Based Writing (Upper Elem/MS/HS)
2ND American Sign Language 2 (MS/HS)
3RD Music & Movement (8 and under)
3RD Older Kids Arts & Crafts (9 and up)
3RD High School History (HS)
4TH Beginner Sewing (ages 8-12)
4TH Drama (All ages)
5TH Geography Through Food (MS/HS)
5TH Drama Supporting Arts (10 and up)
5TH Writing Workshop (HS)
6TH Bible Doodling (Elem/MS)
6TH Beginner Sewing (13 and up)
6TH Biology with Labs (HS)
7TH Dungeons & Dragons Club (HS)
Private Piano Lessons
Private Music Lessons
If selecting "Private Music Lessons" please indicate what instrument in the box below:
Allergies/Medical Conditions:
List the allergy/condition and any special needs or instructions the co-op director and teachers need to be aware of.
Parent Signature:
*
Please verify that you are human
*
Submit
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