Summer Academy 2023 Registration Form: Grades 4-5

To help us expedite the registration process, it is important to ensure that only one(1) record for each family exists in our system. If your child or his/her sibling has attended The Quarry Lane School (Summer Academy or Jr.K-12 program), please indicate so in the questions below.

Is this your first time creating an account with Quarry Lane School?required

Yes

No

NOTE: If you have created an account for the student you are registering OR a sibling of the student at any time (previous Quarry Lane School or summer academy enrollment), please select "No". 

Student's Current Schoolrequired

Quarry Lane

Other

Has your student enrolled in Quarry Lane School or Quarry Lane Summer Academy in the past?required

Yes

No

Has your student been enrolled in the Quarry Lane Summer Academy previously?required

Yes

No

Are you enrolling another student(sibling) for Summer Academy 2023? required

Yes

No

Grade Level in 2022-2023 (Current) School Yearrequired

School Name

Student's Namerequired

First Name

Last Name

Student's Genderrequired

Student's Birthdaterequired

Must contain a date in M/D/YYYY format

Student's Email Address

NOTE: If your student does not have an email address, please do not duplicate the parent's email; leave this field blank instead.

Parent Namerequired

First Name

Last Name

Parent Email Addressrequired

Phone Number required

Street Addressrequired

Cityrequired

State required

Please use state initials

Zip Coderequired

Relationship to Child required

Mother

Father

Guardian

Summer Academy Course Registration

The following Summer Academy classes are offered Monday through Friday. Please refer to the Course Listing page for the designated time for the course selected. Students should be entering the grade levels listed for the 2023-2024 academic year (i.e. a current 4th grade student is a rising 5th grader and is eligible for a 5th grade session.)

Morning SessionsrequiredSelect a morning session summer course.

Dynamics of Critical Reading and Creative Writing (grades 4-5) Session 1: June 12-June 30 ($1,292.00)

Dynamics of Critical Reading and Creative Writing (grades 4-5) Session 2: July 3-July 21 ($1,292.00)

Not enrolling in a morning session.

Select a morning session summer course.

The following Summer Academy classes are offered Monday through Friday during our afternoon session. Please refer to the course description for the designated time for the course selected.

Note that students should be entering the grade levels listed for the 2023-2024 academic year (i.e. a current 5th grade student is a rising 6th grader and is eligible for a 6th grade course).

Afternoon Sessions required

Math Competition Readiness (grades 4-5) Session 1: June 12-June 30 ($1,292.00)

Math Competition Readiness (grades 4-5) Session 2: July 3-July 21 ($1,292.00)

Not enrolling in an afternoon session.

Does your child require special medical attention?required

Yes

No

Please explain:

Are you interested in learning more about annual enrollment in Quarry Lane School?required

Yes, please have someone from the Quarry Lane School Office of Admissions reach out to us with more information.

At this time we are not interested in learning more about annual enrollment in Quarry Lane School.

Part 2: 2023 Summer Academy Agreement

This is a binding contract for The Quarry Lane School. Please read before signing.

This agreement is made by and between

Parentrequired

First Name

Last Name

(hereinafter “Parent(s)” and The Quarry Lane School, (hereinafter referred to as “School”).

Contract Clause #1required

Parent(s) agree and promise to comply with all registration and tuition policies, terms, and conditions of The Quarry Lane School.

Contract Clause #2required

Tuition Payment

The tuition balance for the summer classes due and payable upon signing this enrollment agreement. THIS TUITION IS NON-REFUNDABLE AND NON-TRANSFERABLE.

Parent(s) understand all tuition paid is non-refundable and non-transferable.

Contract Clause #3required

Parent(s) understand that you must purchase your own textbooks for your requested course. (all costs may vary).

Contract Clause #4required

Enrollment Agreement and Parents Liability
Parent(s) understand that their obligation to pay fees for the summer classes are unconditional and that no portion of the fees paid or outstanding will be refunded in the event of absence, suspension, withdrawal, or dismissal from Quarry Lane Summer School. If the student should be withdrawn or dismissed prior to the completion of the summer school course, the tuition is non-refundable and non-transferable.

Contract Clause #5required

Publicity and Photo Release
Parent(s) agree that The Quarry Lane School has the irrevocable right to use their student’s image or likeness, name, voice, student information pertaining to school functions and activities, student work, etc. in, but not limited to, photographs/videos/press releases/radio spots/websites/brochures or other school promotional media without financial compensation for an unlimited time. Parent(s) wishing to decline this Publicity and Photo Release must submit a written request to the Quarry Lane School Main Office. This release does not apply to photographs taken during extra-curricular activities. Students who attend extra-curricular activities forfeit their rights to retain authority over the publication of photos taken.

Contract Clause #6required

Grounds for Dismissal
The Quarry Lane School retains the right to dismiss any student for unsatisfactory conduct on campus or off campus. The delinquency of tuition or any other school fees shall also be grounds for dismissal. The regulations of The Quarry Lane School, specifically including, but not limited to, all policies, rules and regulations specified in The Quarry Lane School Parent/Student Handbook. The School may also terminate enrollment if the student, parent(s) or guardian(s) fail to cooperate with faculty and administration.

Contract Clause #7required

Entire Agreement
This enrollment agreement may not be terminated by parent(s) for reasons of absence or withdrawal of said pupil or for any other reasons. No waiver or modification of this agreement shall be binding upon the parties unless it is in writing and signed by all parties to this agreement. There are no other oral agreements or representations that are not contained in this agreement and any oral evidence of the same shall not be admissible in any civil action or proceeding. This agreement shall be binding on and inure to the benefit of the respective parties, their heirs, legal representatives, successors, and assigns.

Contract Clause #8required

Collection Costs A $30.00 fee will be assessed for returned checks. If collection or legal action is instituted on this enrollment agreement, Parent(s) agree to pay all costs and disbursements including all attorney fees and legal costs incurred to collect and enforce this indebtedness. Any litigation or civil action concerning this agreement shall be venued in a court of competent jurisdiction in Alameda County, California. Time is expressly declared to be of the essence in this Agreement. Any legal proceedings relating to or arising out of collections for late charges and/or tuition, or deposit or any other payment is due shall be governed by the laws of the State of California.

Electronic Signature:

Your electronic signature(s) below constitutes an acceptance of The School’s offer of enrollment for the school year as set forth above.

Accepted by: required

Your name(s) constitutes an acceptance of The School’s Summer Academy Agreement as set forth above.

Date:required

(Must contain a date in M/D/YYYY format)

Summer Academy Registration - Grades 4-5 Courses

Summer Academy 2023 Registration Form: Grades 4-5

Summer Academy Course Registration

Part 2: 2023 Summer Academy Agreement

This is a binding contract for The Quarry Lane School. Please read before signing.

Payment Information