• Eagles on the Rock Bilingual Academy Admission Information

    Eagles on the Rock Bilingual Academy Admission Information

    Please complete the form below to finalize enrollment with our school.

  • Part I (Child Info)

    Part I (Child Info)
  • Child Birth Day*
  • Allergy List

  • School Age Children (only)

  • 5.) Days and Times Needed for Care
    Rows
  • Child's School

  • Part II (Primary Guardians)

    Part II (Primary Guardians)
  • Primary Guardian 1*
  • Primary Guardian 2 (optional)

  • Part III-a (Emergency Contacts)

    Part III-a (Emergency Contacts)
  • Emergency Contact 1*
  • Emergency Contact 2 (optional)

  • Part III-b (Authorized Pickups)

    (optional)
  • Authorized Pickup 1
  • Authorized Pickup 2
  • Authorized Pickup 3
  • Authorized Pickup 4

  • Part IV (Consent Information)

    Part IV (Consent Information)
  • 1.) Transportation - I give consent for my child to be transported and supervised by operation's employees
  • 2.) Field Trips
  • 3.) Water Activities - I give consent for my child to participate in the following water activities
  • 3.) Photos - I give consent for my child to be photographed for the following purposes

  • Part V (Medical Information)

    Part V (Medical Information)

  • Authorization for Emergency Medical Attention

    In the event I cannot be reached to make arrangements for medical care, I authorize the person in charge to take my child to:
  • Physician*
  • Emergency Care Facility*

  • Vaccine/Vision/Hearing Information

  • Requirements for Vaccine Exclusion
  • Browse Files
    Cancelof

  • Part VI (Privacy & Signature)

    Part VI (Privacy & Signature)

  • Gang Free Zone

    Under the Texas Penal Code, any area within 1,000 feet of a child care center is a gang-free zone, where criminal offenses related to organized criminal activity are subject to harsher penalties.

  • Privacy Statement

    HHSC values your privacy. For more information, read our privacy policy online at: https://hhs.texas.gov/policies-practices-privacy#security

  • Part VII (Tuition & Payment)

    Part VII (Tuition & Payment)

  • Tuition/Payment

    I agree that payment is due on or before the 1st of every month. I understand that 30 days in advance written notice must be given if I decide to discontinue Eagles On The Rock Academy. Without notice, 1 month tuition will be charged. In addition, agree to pay any outstanding balance.
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