CDF Freedom Schools Online Summer Program - Child Enrollment Form, 2020 (Excel Academy)

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Please complete an enrollment form for each child you would like to enroll in CDF Freedom Schools Summer 2020 program at Excel Academy. Please note that your child(ren) must be enrolled in grades 2-5 in order to be eligible for this program. Enrollment is one a first-come, first-serve basis.

I hereby authorize and consent DCPS Office of the Chief of Staff to provide information concerning the education of my child, to the Children's Defense Fund and the DC Office of Out of School Time Grants and Youth Outcomes (OST Office). I further authorize the release of educational records of my child for the current school year to the parties listed above that include the following information: education transcripts, school/program enrollment information, universal student ID, attendance data, credit history, grades, assessment data, IEP information and graduation attainment (12th grade only). This authorization and release shall remain in effect from June 1, 2020 – August 31, 2020. By signing below, 1) I acknowledge and understand that I have the opportunity to review the records to be disclosed and the right to challenge the contents of such records, and 2) I am at least 18 years of age or I am signing this document on behalf of my child because he/she is not 18 years of age.

Yes

Today's Date *

YYYY

In light of COVID-19, this site will prepare for a virtual summer with enrichment activities online and book/supply drop-offs throughout the summer program, are you interested in enrolling your child in the Virtual Freedom Schools summer program?

Yes

Maybe

Clear selection

If COVID-19 restrictions are lifted and DCPS schools reopen during the summer months, would you want to enroll your child at the school site?

Yes

Maybe

Clear selection

Please check the technology and learning space available to the scholar at home?

Computer, Tablet, or Laptop

Cellphone

Internet (wifi)

Designated learning space (e.g. quiet environment, desk, light, etc)

An adult or older family member who can assist with login steps, story-time (reading), activity completion, etc.)

Do you have any concerns about returning to school during COVID-19? (Brief explanation)

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