Christian Homeschoolers Academy of Tutoring Family Registration: 2008-2009 School Year

For Office Use Only DRR___________

Family Information

Father's Last Name:		Father's First Name:
Mother's Last Name:		Mother's First Name:
Address:	City:			State:	Zip Code:
Home Phone: ( )			Emergency Contact Person:
Alternate Phone: ( )			Emergency Phone Number: ( )
Email: (Email address must be included before processing will occur for your family)
Is any of the above information different from previous CHAT registrations (returning families only)? Yes No
Would you like to be included in a CHAT directory to be made available only to CHAT families? Yes No

Student Information

Student Name

Birth Date

Age as of Sept. 1, 2008

Grade for 2008-09

Number of years home educated

We have read the statement of faith for Christian Homeschool Academy of Tutoring (CHAT) and agree to allow my student(s) to be

instructed according to the principles stated and our student(s) accepts this statement to be the foundation for all instruction at CHAT.

We have read the Code of Conduct and agree to abide by the expectations. We also agree to the consequences listed.

I/we have also read and understand the open campus description and know that CHAT will only monitor students within the rented

boundaries on the inside of City Hill Fellowship.

Father's Signature________________________________________________ Date ________________________

Mother's Signature________________________________________________ Date _________________________

Student Signature_________________________________________________ Date _________________________

Student Signature_________________________________________________ Date _________________________

Student Signature_________________________________________________ Date _________________________

For your registration and enrollment to be processed, please make sure you have included:	Mail all registrations to: CHAT 3430 Robinwood Terrace Minnetonka, MN 55305
Completed Family Registration Form Registration Fee of $40 Completed registration form for each day Tuition payments for each class registered for Signed Legal Waiver Form Signed Student driver form, if required Completed Medical Release/Health Information form Materials fee checks made out to tutors, if required.