FPA Registration

First Presbyterian Academy at Shannon Forest
Student Registration

Once you complete the registration form below, you will be required to pay the registration fee of $150 to submit your registration form.

**Scholarships are available. Please contact us at [email protected] for more information or to apply for a scholarship.

Additional Information:

* Indicates required field

Student's Name: *

First

Last

Birthday: Month *

Day *

Year *

Student's Email Address *

Address: *

Line 1

Line 2

City

State

Zip Code

Country

School: *

Student's Grade: *

Student's Homeroom Teacher (for 4th/5th Grade only): *

Does your student have any allergies? *

If Yes, please list: *

Does your student require the use of an epi-pen? *

Please list any information you would like us to know about your child: *

Does your student require any accommodations to be an active participant in the program? *

If yes, please list requested accommodations: *

Parent/Guardian #1 Name: *

First

Last

Parent/Guardian #1 Email: *

Phone Number: *

Parent/Guardian #2 Name: *

First

Last

Parent/Guardian #2 Email: *

Phone Number: *

At dismissal each week, your student will... *

Please list everyone authorized to pick up your student: *

RELEASE OF LIABILITY: I understand that in the event of a medical emergency, representatives of BRIDGED will act on my behalf to render assistance and that I will be financially responsible for any expenses involved. I release the school my student attends and BRIDGED and all of their corresponding representatives from all liability pertaining to my student’s involvement in this program. I acknowledge that my student is participating in this program at his or her own risk.
DISMISSAL POLICY: Please arrive to pick up your student promptly at the end of each meeting. A proper car tag is required in order for your student to be dismissed. For safety reasons, students will not be released without proper identification.
REFUND POLICY: Refunds will not be issued for non-attendance at a scheduled meeting. Should BRIDGED find it necessary to cancel registration for a student, a refund will be issued after deduction for meetings already attended and expenses incurred.
MEDIA RELEASE: I give permission to use my student’s photographic portraits, pictures, digital images, audio recordings or videotapes publicly for promotional purposes. I understand that the images may be used in print publications, online publications, presentations, websites and social media. I also understand that no royalty, fee or other compensations shall become payable to me by reason of such use.
MAKE-UP CLASSES & CANCELLATIONS: BRIDGED reserves the right to cancel any program due to insufficient enrollment. Upon cancellation a full refund will be made. In the event that a meeting is canceled for weather-related reasons, a makeup class will be rescheduled if possible, but it is not guaranteed and may not always be possible. No refund will be given if a class is canceled due to weather events or acts of nature.

The following are the expectations for students. I understand that my student can be dismissed from the program if they do not follow the expectations below:

Arrive on time to weekly meetings
Attend all weekly meetings
Follow your school’s rules
Be kind and treat others as valuable
Be respectful to the leaders and other volunteers

Please check the box below if you agree *

I have read the above statements and agree to all of the above.

CONTINUE TO PAYMENT

First Presbyterian Academy at Shannon Forest
Student Registration

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BRIDGED, Inc.

Bridged, Inc. is a 501(c)(3) nonprofit organization. Your support allows our organization to promote awareness, connection and inclusion of people with disabilities in their communities.
EIN 88-4119195

First Presbyterian Academy at Shannon Forest​Student Registration

Quick Links:Home ​Public School ProgramsPrivate School ProgramsVision, Mission & ValuesDonate Today!

Connect With Us:

BRIDGED, Inc.

​​Bridged, Inc. is a 501(c)(3) nonprofit organization. Your support allows our organization to promote awareness, connection and inclusion of people with disabilities in their communities.EIN 88-4119195

First Presbyterian Academy at Shannon Forest
Student Registration

Quick Links:
Home
Public School Programs
Private School Programs
Vision, Mission & Values
Donate Today!

Bridged, Inc. is a 501(c)(3) nonprofit organization. Your support allows our organization to promote awareness, connection and inclusion of people with disabilities in their communities.
EIN 88-4119195