COLTS Registration Form
The Center of Learning and Therapy Services provides resources to help meet the needs of all learners while advocating for our learning different students and acting as a resource to parents and teachers. Students will come to COLTS during the school day. COLTS will provide an individual service plan, weekly updates, meet with parents and teachers as needed.

If you have any questions please email naomijennings@bayouacademy.net or visit our website https://www.bayouacademy.net/apps/pages/index.jsp?uREC_ID=2144776&type=d&pREC_ID=2179942
 
Email *
Student Name 
Student Grade for 2023-2024 School year 
Does your child have a diagnosis? If so please explain.
Parent Name 
Parents Email 
Payment Options. (No payment due until September 1)
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Membership Agreement/Contract: In consideration of my child’s participation in Bayou Academy’s COLTS Program, I hereby agree to be bound to each of the following:    • In the event I can’t be reached, and my child needs immediate medical attention, I hereby authorize Bayou Academy and/or staff to obtain medical treatment for my child at a local area clinic or hospital. I am personally responsible for the medical expenses.  • I understand that Bayou Academy and staff shall have the right to display, use, post on social media and/or advertise any photographs, film and/or video taken of my child in connection with these classes and subsequent programs.  • I understand for misconduct my child will result in dismissal from COLTS for the day without refund.  • I understand parents aren’t permitted to stay in therapy/ learning sessions. • I understand I am signing my child up for the Center Of Learning & Therapy Services, a contract from August 2023 - May 2024. I will NOT receive reimbursement of any sort due to absentees, dropping out, other commitments or activities that arise and conflict with therapy/ learning sessions.                                                                         *COLTS strives not only to provide students with academic application strategies, but most importantly self-confidence!                                                                         Please type your name and date (this serves as an electronic signature).
We want to offer a safe learning environment that will help your child succeed. Is there anything you would like the COLTS team to know about your child?
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