KOLA Academy Enrollment Form

01

Student information

Student full name*

Required

Date of birth*

Required

Age

Home address*

Required

City*

Required

Postal code*

Required

Parent or guardian name*

Required

Relationship to student*

Required

Parent phone*

Required

Parent email*

Valid email required

02

Learning profile

Academic strengths and favourite subjects

Learning challenges or areas needing support*

Previous educational settings*

Has your child had any formal assessments?*

Yes No

If yes, please email details to [email protected]

03

Health and safety

Medical information* N/A

Please share medical information or check N/A

Support needs* N/A

Please share support needs or check N/A

Family doctor and clinic*

Required

Preferred hospital or facility*

Required

Primary emergency contact

Name*

Required

Relationship*

Required

Primary phone*

Required

04

Outdoor experience

Weather concerns, animal or insect fears, or related allergies*

Required (write None if not applicable)

Previous outdoor experience (programs, camps, activities)

05

Communication and payment preferences

Are you enrolled in a Distributed Learning (DL) school or registered homeschool?*

DL school Registered homeschool No, not enrolled

Which one?

How will tuition be covered?*

Required

Preferred payment method (if paying out of pocket)*

Monthly bank transfer Term payment Annual payment (5% discount) Credit card (2.5% fee)

Preferred communication method*

Email Text message Phone call

06

Family goals

What are your goals for your child at KOLA Academy?*

Required

Anything else we should know about your child?

07

Agreements and signature

I consent to internal documentation

Required for enrollment

Yes, I consent No, please do not use my child's image publicly

Please select an option

I have read and agree to KOLA Academy's enrollment terms, tuition schedule, and attendance policies. I authorize KOLA Academy staff to seek emergency medical treatment for my child if I cannot be reached. I understand that outdoor education involves inherent risks and that KOLA Academy takes appropriate safety precautions. I confirm that all information provided is accurate and I will notify KOLA Academy of any changes.

All four agreements must be checked

Parent or guardian signature*

Signature required

Print name*

Required

Date*

Required

Relationship to child*

Required