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Application

Child's Information:

First Name

MiddleName

Last Name

Age

Present Grade (If Applicable)

Birthday

Gender

Parent's Information:

First Name

Last Name

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Cell Phone Number

Work Phone Number

Second Parent Information:

First Name

Last Name

Street Address

Street Address Line 2

City

Region/State/Province

Postal / Zip code

Country

Cell Phone Number

Work Phone Number

Health:

List any allergies your child may have:

List any medications your child is taking:

If your child has a special diet list it below:

List all foods your child is not allowed to have:

List any medical diagnosis your child may have:

If your child is taking any therapies please list them below:

Please explain any other important health information we should be aware of. For example: seizures, panic attacks, etc.

Educational History

How is the student currently enrolled?

Public School

Charter School

Private School

Homeschool

School student is currently enrolled at:

Has the student ever been evaluated for educational, learning, behavioral, or emotional reasons?

Has your child ever repeated a grade level? If so, what grade?

Please type below the classes or days for which you are enrolling your child.

How will your child be attending classes?

In Person

Online

Hybrid: Online & In Person

How did you hear about Learning Cove Academy?

Friend

Online Search

Instagram

Facebook

Parent Organization

Therapist

Other

FEES

Registration and Assessment
There is a non-refundable registration fee to reserve a position for Learning Cove Academy. The registration fee for new students attending two or more full days per week is $150. After the registration fee is received an assessment will be scheduled for new students for $50. After the assessment if it is found that Learning Cove Academy is not an appropriate setting for the student the registration fee may be returned but the assessment fee of $50 will not be returned. Select to sign below to state that you understand and agree with these terms.

Your Signature

Fees for Students Attending Less than 2 Full Days per Week
The non-refundable registration fee for part time students attending less than two full days per week is $50. The materials fee will be discussed and paid after classes are selected. An assessment may by required depending on the classes the student is taking. Select to sign below to state that you understand and agree with these terms.

Your Signature

Thanks for submitting!

Learning Cove Academy
3350 SW 144 Ave
Miami, Florida 33175
Phone: 786-321-5683 email: learningcoveacademy@gmail.com

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