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LIFE ACADEMY

Enrollment Form

Page 1 of 9
Minimum age at which a child may enter.

(a) A child who is six years of age on or before December 31st or the date on which school begins in the enrolling district shall be entitled to admission to the first grade in the public elementary schools at the opening of such schools for that school year or as soon as practicable thereafter. A child who is under six years of age on December 31 or the date on which school begins in the enrolling district shall not be entitled to admission to the first grade in the public elementary schools during that school year, except that an underage child who transfers from the first grade of a school in another state may be admitted to school upon approval of the board of education in authority, and an underage child who has moved into this state having completed or graduated from a mandated kindergarten program in another state shall be entitled to admission to the public elementary schools regardless of age. A child who becomes six years of age on or before February 1 may, on approval of the local board of education, be admitted at the beginning of the second semester of that school year to schools in school systems having semiannual promotions of pupils.

(b) A child who is five years of age on or before September 1st or the date on which school begins in the enrolling district shall be entitled to admission to the local public school kindergartens at the opening of such schools for that school year or as soon as practicable thereafter; a child who is under five years of age on September 1 or the date on which school begins in the enrolling district shall not be entitled to admission to such schools during that school year; except that, an underage child who transfers from the public school kindergarten in another state may be admitted to local public kindergarten on the prior approval of the local board of education on a space-available basis. The underage children transferring from the public-school kindergartens of another state, upon successful completion of kindergarten in the local public schools, will then be allowed admission to the first grade of the local public schools.

STUDENT ENROLLMENT

Documents Required for School Admission

Any student entering LIFE Academy, regardless of grade level, shall be required to submit the following:

1. Parent/Guardian Photo ID - Valid Alabama driver’s or non-driver's license or Military ID

2. Student's birth certificate-proof of age and verification of legal guardianship- if different from the birth certificate.

3. A current State of Alabama Certificate of Immunization

Mandatory Immunization Law- Each child enrolled in daycare, Head Start, and public or private school in Alabama must have a valid Alabama Certificate of Immunization on file at the facility they attend. The certificate may be obtained from the physician or clinic that administers the vaccine or may be completed by any county health department in the state if the parent presents a vaccine record from the provider. For students who are moving to Alabama, out-of-state vaccine records must be transferred to the Alabama Certificate of Immunization before enrollment in daycare, Head Start, or school entry. This may be accomplished by taking a vaccine record from the provider to the local county health department, or if a physician in Alabama has been chosen by the family, the record may be transposed by the physician. The State of Alabama does not recognize philosophical, moral, or ethical exemptions from vaccination. A medical exemption may be used by a physician, or an Alabama Certificate of Religious Exemption may be obtained from the local county health department. Attendees of daycare and Head Start must be age-appropriately vaccinated against Diphtheria, Tetanus, Pertussis, Measles, Mumps, Rubella, Haemophilus Influenzae Type B, Polio, and Chickenpox.

4. Two proofs of residence- At least two primary proofs of residency are required annually at registration and may be requested throughout the school year. All documents submitted as proof of residence must contain the parent or legal guardian's physical address for the school to verify that the residence is in the zone. (No Post Office Box address will be accepted)

B. Provision for Determining Residence of Students

At the beginning of each school year and with each residence change, the school shall obtain from the parent/guardian at least two (2) proofs of residency as described below to demonstrate residency at the address given. The documentation should be kept as a part of the student record. Proof of residency may be requested again within 90 days of starting school, beginning a new semester, and/or any time the principal deems necessary.

C. Forms of Acceptable Proof of Residence

Required - TWO documents that reflect a student's physical residence - Must submit at least one primary proof.

Primary Proofs of Residence:

1. Utility Bills or Deposit Receipts- for electric, gas or water service only. Must be current within 30 days- for electric, gas, or water service- No disconnect notices allowed

2. Mortgage Statement

Monthly mortgage statement- must be current-within 30 days

Secondary Proofs of Residence:

1. Property Tax Records or Deeds- Tax Receipt, Property Deed (Please blacken out any

personal financial information

2. Income Tax Records- Correspondence from the IRS

3. Correspondence from Social Security Office

4. Correspondence from other V.S. government agencies- (Department of Human Resources, Food Stamp Office)

5. Employment Records- Paycheck stub issued from the employer showing the physical address of

The employee within the last 30 days

D. Parent/ Custody Issues

Due to the overwhelming number of custody issues involving students, all LIFE Academy employees will follow the procedure as outlined below relating to non-custodial parents' access to student records and visitation. School system employees should not be placed in the position of reading and attempting to interpret divorce decrees to resolve custody issues.

As completed by enrolling parents, the student enrollment card should govern issues related to pick up, visitation, etc. of students at school. The non-custodial parent has the right to receive copies of the child/children's educational records, including, but not limited to, a copy of report cards, unless such rights have been specifically revoked by a court order or other legally binding document. Any specific custody issue should be forwarded to Montgomery Public Schools' board attorney, along with a copy of the enrollment card and custody paperwork- for review and final interpretation. The primary purpose of our schools is to provide a safe learning environment for all students with our focus on instruction. The schools should not become the environment for parental custody disputes

Student Information

*The above question is about ethnicity, not race. No matter what you selected above, please continue to answer the following Question 2 by marking one or more boxes to indicate what you consider your student's race to be.

Additional Services

The Information provided below will help the school determine if the student qualifies for additional services.  

Please check YES or No for each question below.

HOUSING STATUS:

Life Academy Language Survey

Parent/Guardian Information

EMERGENCY CONTACT

Emergency Contact #1

(IN ACCORDANCE WITH SCHOOL SYSTEM CHECK-OUT PROCEDURES)


Emergency Contact #2

(IN ACCORDANCE WITH SCHOOL SYSTEM CHECK-OUT PROCEDURES)


Emergency Contact #3

(IN ACCORDANCE WITH SCHOOL SYSTEM CHECK-OUT PROCEDURES)


Emergency Contact #4

(IN ACCORDANCE WITH SCHOOL SYSTEM CHECK-OUT PROCEDURES)


Parent Volunteer Form

Select all that apply

I fully understand and agree to assume all risks involved in all duties I perform in a volunteer capacity on behalf of or in connection with Life Academy. I agree not to hold Life Academy responsible for any injury(s) or loss of damages that I might sustain during my volunteer duties.  This waiver includes me, all my family members, and my descendants forever from seeking any legal action against Life Academy, Inc. Life Academy, its successor organizations, or any representatives thereof.  By checking the box below, I hereby grant Life Academy the perpetual right and license to use my name, voice, and comments in any of its materials, including print, digital, or audio, for internal and external audiences. These materials include but are not limited to: photographs, advertisements, brochures, viewbooks, news releases, newspapers, newsletters, radio, video, websites, electronic mail, and social media accounts. Instructions: This agreement must be signed by ALL Volunteers before performing any services relating to activities of Life Academy. This includes, but is not limited to, registration day, painting, landscaping, cleaning, moving furniture, and or materials.  Please print and sign the agreement and send it by mail, email, or delivery in person to a Life Academy representative. - Thank You, Jamia Anderson Executive Director​

Universal Field Trip Permission Form

I give permission for my child to accompany his/her class on all LIFE Academy-sponsored field trips. The school will provide me with information regarding individual trips in advance of all field trips. 

• I understand that I will be notified in advance of any cost, the date and time of departure, and the anticipated return time.

 In granting permission, I assume responsibility for any damage to person(s) or property that might be caused by my child while they are participating in a field trip. 

• I agree that if it is necessary for my child to receive medical treatment during the trip, I will be contacted and responsible for all relevant medical costs. 

• I agree that if the behavior or health of my child should result in him/her being sent home before the expected return time, I will be responsible for making the necessary arrangements.

 • I agree that I will not hold Montgomery Public Schools responsible for any loss of personal property while on a field trip.

 • I understand that I have the right to refuse that my child attends any field trip.

I certify that I am the parent/legal guardian of

And I understand that all school policies and procedures, including those outlined in the Code of Student Behavior, will apply to my child while on school-sponsored field trips. ​

Student Media Release Form

I hereby give LIFE Academy the right and permission to publish and use photographs, video, and/or audio recordings of my child, a student enrolled in LIFE Academy.

I understand that such reproductions could be used to publicize or promote the school system and/or my child's school through its own media productions (district Website, social media, printed and/or online brochures, reports, promotional videos, etc.) or through the commercial media (television, radio, internet or print).

 I waive any right to inspect and/or approve the finished product and do release LIFE Academy from any liability by virtue of distortion by processing. I further agree that these items may be used for publication, broadcast, and reproduction without limitation, reservation, or any fee

I certify that I am the parent/legal guardian of

Final Step

Proof of age and verification of legal guardianship- if different from the birth certificate.

Forms of Acceptable Proof of Residence Required - TWO documents that reflect a student's physical residence - Must submit at least one primary proof. Primary Proofs of Residence: 1. Utility Bills or Deposit Receipts- for electric, gas or water service only. Must be current within 30 days- for electric, gas, or water service- No disconnect notices allowed 2. Mortgage Statement (Monthly mortgage statement- must be current-within 30 days)

Forms of Acceptable Secondary Proofs of Residence: 1. Property Tax Records or Deeds- Tax Receipt, Property Deed (Please blacken out any personal financial information) 2. Income Tax Records- Correspondence from the IRS 3. Correspondence from Social Security Office 4. Correspondence from other V.S. government agencies- (Department of Human Resources, Food Stamp Office) 5. Employment Records- Paycheck stub issued from the employer showing the physical address of The employee within the last 30 days