Class Registration Signup Form

CLOSED CLASSES:

Kindergarten, 2nd, 3rd, 5th, 6th, 7th, 8th, ASL 1
Last Name of Family*
First Name of Child*
Birth Date*

MonthDayYear
25-26 Grade*
FOR HIGH SCHOOL - First Hour Class: 930-1025

World HistoryWorld GeographyAlgebra 2 (additional fee)No Class
FOR HIGH SCHOOL ONLY - Second Hour Class: 1030-1125

Government (sem 1)Economics (sem 2)BiologyPhysical SciencePre Algebra (additional fee) (7th & 8th graders can take this course)No Class
FOR HIGH SCHOOL ONLY - Third Hour Class: 1155-1250

ChemistryAnatomy & PhysiologyGeometry (additional fee)English (addiitonal fee)No Class
FOR HIGH SCHOOL ONLY - Fourth Hour Class: 1255-150

American HistoryAmerican Sign Language (additional fee)Algebra 1 (additional fee)No Class
First Name
Birth Date

MonthDayYear
25-26 Grade
FOR HIGH SCHOOL - First Hour Class: 930-1025

World HistoryWorld GeographyAlgebra 2 (additional fee)No Class
FOR HIGH SCHOOL ONLY - Second Hour Class: 1030-1125

Government (sem 1)Economics (sem 2)BiologyPhysical SciencePre Algebra (additional fee) (7th & 8th graders can take this course)No Class
FOR HIGH SCHOOL ONLY - Third Hour Class: 1155-1250

ChemistryAnatomy & PhysiologyGeometry (additional fee)English (additonal fee)No Class
FOR HIGH SCHOOL ONLY - Fourth Hour Class: 1255-150

American HistoryAmerican Sign Language (additional fee)Algebra 1 (additional fee)No Class
First Name
Birth Date

MonthDayYear
25-26 Grade
If this child is in high school, please look at the above options for each hour and include the classes you would like him/her to take in the box below.
First Name
Birth Date

MonthDayYear
25-26 Grade
First Name
Birth Date

MonthDayYear
25-26 Grade
First Name
Birth Date

MonthDayYear
25-26 Grade
Parent's Name*

FatherMother
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Mobile Number

Area CodePhone Number
Are you able to receive text messages?

Yes - This is a great way to contact me.No
Home Phone Number

Area CodePhone Number
What number would you like me to put on the schedule sheet? This will be used by other mothers/fathers who may need to contact you in regards to swapping schedules or class plans.

Mobile NumberHome Phone NumberOther
Who will be fulfilling the role of helping at co-op every other week?
If you would like to discuss the possibility of working every week or not working at co-op (drop off) please make note of that above.
Parent Email*
Please make note of any special needs we should be made aware of for your child(ren). This may include allergies, academic needs, or other concerns.
Please list any special gifts or talents you have that you would like to utilize at co-op.
We'd love to have you share at co-op! Do you have any experience in other countries, unique careers, or anything else you think may be enjoyed by the families/children at co-op?
Which age group/area would you like to be involved with on the weeks you are working at co-op? PLEASE NOTE THAT DROP OFF IS NOT AN OPTION UNLESS YOU SPEAK DIRECTLY WITH MINDY. WE ARE UNABLE TO PROVIDE THIS AS AN OPTION UNTIL ALL ROOM PARENTS SLOTS ARE FILLED.

NurseryPreschool Class (3 Year Old)Pre K Class (4 Year Old)KindergartenFirst GradeSecond GradeThird GradeFourth GradeFifth GradeSixth GradeSeventh GradeEighth GradeArt or Craft ActivitiesPERead AloudMorning Devotions/Daily DevotionalsHigh School (Grading Assistant)Hall Monitor/Welcome Desk MonitorLunchroom Set Up/Supervise/Clean Up/Tear Down
Are you currently CPR and/or first aid certified? (this is not required)

CPRFirst AidCPR & First Aid
Who (other than the parents) will be able to pick your child(ren) up? This list is not final and can be altered on any particular Friday when you sign your child in.
NEW FAMILIES: How did you hear about us?
RETURNING & NEW FAMILIES: Why do you want to be a part of CHC for the upcoming year?
Please acknowledge each statement below by marking each box.*

I will be faithful to and punctual for my role at co-op whether it be a room parent, teacher, or assisting in some other way.I realize that the upper level courses at co-op are for credit courses. As such I will make sure that I communicate with the teacher when I have concerns or questions about the class and/or assignments. I will also consistently check the online system, so I know how my child is performing in his/her classes (6th grade and up).I understand that my children are expected to complete the assignments as set forth by their teachers, especially in the upper grades. Instances of cheating and/or plagiarism will be dealt with through a zero grade first and if it occurs again a possible removal from the class or co-op.I will fulfill the pre-determined financial commitments which support the endeavors of the co-op. I realize that if I do not fulfill this obligation, I may be asked to cease attendance.All activities planned by co-op will be conducted in a safe and orderly manner to the best of our abilities and knowledge (including on site or off site for field trips). However, CHC, nor anyone serving as a representative of CHC accept or implies liability for anyone taking part in the activities. CHC retains the right to decline or discontinue anyone’s participation in any activity at any time at its sole discretion. Normal precautions are always taken to ensure the safety of everyone that is participating. You and/or your child are attending at your own risk and assume all risks on behalf of yourself and your child(ren). You shall release, indemnify, defend, and hold harmless CHC and its representatives from all liability to the fullest extent permissible by law.
Enter the message as it's shown*
Upon submitting your registration form the director will follow up to either confirm your information or to set up a meeting if you are a new family.
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CLOSED CLASSES: