Admissions 2022/2023

First Carpool Contact
Please list the people that you would like to authorize to pick up your child. We will not release your child, under any circumstance, to anyone other than his/her parents without written permission.
First Last
First Carpool Contact Phone
Second Carpool Contact
First Last
Second Carpool Contact Phone
Emergency Contact
Please list local persons other than regular carpool drivers that we may call in case of an emergency if you cannot be reached and that has permission to pick up your child.
First Emergency Contact Name*
We will contact this person after attempting to contact Parent 1 and Parent 2.
First Last
First Emergency Contact Phone*
Second Emergency Contact Name
First Last
Second Emergency Contact Phone

Medical Information
Child's Physician*
First Last
Physician's Phone Number*
Insurance Company*
Insurance Company Phone Number*
Insurance Group Number*
Insurance Company Address*
Street Address Address Line 2 City State ZIP Code
Health Problems, Allergies, or other important information
Please list any allergies, health concerns, or other important information we should know about your child. Please make sure your child's teachers and the school Director understand the severity of any allergies.
Symptoms displayed when having an allergic reaction:

Policies, Tuition, Consent:
Health Insurance*
*I understand all children enrolled at The Spanish Academy are required to have health insurance.
- I have read and agree to the policies listed above.
Emergency Medical Agreement*
Should my child suffer an injury or illness while in the care of The Spanish Academy, and the school is unable to contact me (us) immediately, it shall be authorized to secure medical attention and care for my child as may be necessary. I (we) assume responsibility for payment of services. I (we) agree to keep the school informed of changes in telephone numbers where I (we) can be reached.
- I have read and agree to abide by the policies listed above.
Immunization Form 3231*
All children attending The Spanish Academy are to be age appropriately immunized with all the required vaccines before the start of school and must have an updated form 3231 Immunization on file.
- I have read and agree to abide by the policies listed above.
Pictures and video for marketing*
*I understand candid pictures and video of children at The Spanish Academy may be used for advertising purposes unless the administration has been notified otherwise.
- I have read and agree to abide by the policies listed above.
Consent
**Click here for policies and tuition information**
I have read and been made aware of the policies:

Billing Information
Lastly, please fill out your information and preferred email for the billing information below.

We confidently use Stripe payments and trust your credit card information is safe and secure.
Name*
First Last
Email*
Buckhead Prechool/Kinder Registration Fee*
A non-refundable* registration fee is due to secure your child's spot. (*In the event the class is full, the fee will be refunded.)
Price:
East Cobb - Prechool/Kinder Registration Fee*
A non-refundable* registration fee is due to secure your child's spot. (*In the event the class is full, the fee will be refunded.)
Price:
Emory Prechool/Kinder Registration Fee*
A non-refundable* registration fee is due to secure your child's spot. (*In the event the class is full, the fee will be refunded.)
Price:
Suwanee Prechool/Kinder Registration Fee*
A non-refundable* registration fee is due to secure your child's spot. (*In the event the class is full, the fee will be refunded.)
Price:
Total
$0.00
Coupon
Credit Card
Card Details
Cardholder Name
Name
This field is for validation purposes and should be left unchanged.

Personal Data