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CGR Learning Lab Enrollment Form 2020-21
Learning Center/Education Consulting Enrollment Form
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* Indicates required question
Email
*
Your email
Language
*
Choose
Spanish
French
English only
Student Information - Name
*
Your answer
Student Information - Birthday
*
MM
/
DD
/
YYYY
Student Information - Sex
*
Choose
Male
Female
Student Information - School
*
Your answer
Student Information - Grade (2020-21)
*
Choose
K
1st
2nd
3rd
4th
5th
6th
7th
8th
Parent Contact 1 - Name
*
Your answer
Parent Contact 1 - Cell Phone
*
Your answer
Parent Contact 1 - Cell Phone Provider
*
Your answer
Parent Contact 1 - Work Phone
*
Your answer
Parent Contact 1 - Home Address
*
Your answer
Parent Contact 1 - Work Address
*
Your answer
COVID-19 Exposure - Do you agree to answer daily questions concerning COVID-19 exposure, based on you, your child and all household members?
*
Choose
Yes
No
COVID-19 Exposure - Do you agree to provide daily temperature readings, prior to your student(s) attending the center?
*
Choose
Yes
No
COVID-19 Exposure - Do you agree to immediately notify CGR Learning Center concerning any exposure to COVID-19 as it relates to you, your student(s) and all household members?
*
Choose
Yes
No
Have you read and agreed to all CGR Learning Center program rules -
http://cgrkids.org/policies
*
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Yes
No
I acknowledge that enrollment is not complete and my child can NOT attend CGR Learning Center until all required MSDE/Office of Childcare forms are returned to CGR:
http://cgrkids.org/msdeforms
*
Choose
Yes
No
I understand that my child must have a NEGATIVE Covid-19 test from a 3rd party facility, taken on/no later than Sep. 5, 2021: *
*
YES
No
I acknowledge that enrollment requires a deposit of $550 per child and recurring payments due bi-weekly through June 14, 2022. Payments can be made via Zelle (
tuition@cgracademy.org
) or check (CGR Academy, 10274 Lake Arbor Way #205, Bowie, MD 20721). Credit cards are not accepted for this program. *
Yes
No
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Please provide your requested Learning Pod schedule. Please note, these time slots are assigned on a first come/first served basis to ensure 6 Feet of separation at drop off for all families.
*
8:00am - 5:00pm
8:15am - 5:15pm
Other:
I acknowledge that REFUNDS AND CANCELLATIONS are NOT PERMITTED once enrollment has been confirmed. Withdrawal requires 30 days notice.
*
Yes
No
A copy of your responses will be emailed to the address you provided.
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