Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.We are excited that you are considering registering/re-enrolling with us at CJE. Please take the time to fill out the information below. We recommend using a computer or laptop, as the mobile application may not submit properly. Additional Documents you will need to upload: 1. Copy of the child's most recent report card, progress report, or transcripts 2. Parent/Guardian Photo ID 3. Proof of income if applying for reduced rate scholarship (w2s, last 2 check stubs, or documentation with monthly income from governmental assistance programs) Student's Name *Student's Email Address *Parent/Guardian Name *Parent/Guardian Email *Registration Period *WinterSpringSummerFallYear of Registration *Program *AfterschoolRider's United (must be an advanced rider)Summer SessionGroup/Organization (if any-example Girl Scouts, Mandela Acadamy, Jack and Jill, etc. If none, put NA) *ContinueStudent Information Child 1/Participant Name *Gender child 1 *Date of Birth child 1 *Age child 1 *Child 2/Participant NameGender child 2Date of Birth child 2Age child 2Child 3/Participant NameGender child 3Date of Birth child 3Age child 3Address *City *Zip Code *Parent/Legal Guardian Information Mother's Name/ or Guardian (A) *Mother/Guardian (A) email *Mother's Name/ or Guardian (A) Cell Phone *Please indicate your relationship to the child/participant: (A) *Natural/Birth MotherNatural/Birth FatherLegal GuardianFoster/Resource ParentOtherIf Other please specify: (A)Father's Name/ or Guardian (B)Father/Guardian (B) emailFather's Name/ or Guardian (B) Cell PhonePlease indicate your relationship to the child/participant: (B)Natural/Birth MotherNatural/Birth FatherLegal GuardianFoster/Resource ParentOtherIf Other please specify: (B)Emergency & Special Information Emergency Contact (age 18 or older) *Relationship to Child/Participant *Phone Number *Does your child have any allergies to food, insects, etc.? *YesNoIf yes please specify. If you are completing the application for more than one child please specify by nameIf your child has any physical, emotional, or psychological issues, please describe here: (please note that CJE may not be able to accomodate certain behaviors at this time)Names of people allowed to pick up your child(ren)Household size (number of people living in your home including adults and minors) *BackContinueDoes the child/participant have special dietary requirements or allergic reactions? *YesNoIf yes please specify. If you are completing the application for more than one child please specify by name Medical Release I have read and accepted the terms of this Medical Release Form waiver. I certify that I understand and accept, thus giving my consent to the Compton Jr. Equestrians Program to provide any emergency medical treatment my child(ren) may need. * Clear Signature BackContinueCheckboxes *I agree to adhere to the following attendance policies based on the program in which I will be enrolling in1. Afterschool Program minimum of 3 days per week 2. CJE Rider's United a minimum of once per week. Checkboxes *I understand that I will be required to volunteer in the program (i.e. shows, events, snacks, program, etc)Checkboxes *I understand that applying for reduced rate scholarship does not guarantee that I will receive a reduced rate.Checkboxes *I agree to pay the full tuition amount for my program if I am ineligible for a scholarship due to failure to submit documents, income ineligibilty, or other reasons that deemed ineligibleCheckboxes *I agree to pay the full tuition amount for my program if I am ineligible for a scholarship due to failure to submit documents, income ineligibilty, or other reasons that deemed ineligibleCheckboxes *I will adhere to evaluations requirement (i.e. report cards, quizzes, surveys, assignments, etc)Checkboxes (copy) (copy) *I accept the consequences of failing to comply. Consequences include a written warning via email, inegilbity to partipate in shows and events, suspension, and expulsionYour Signature * Clear Signature Date *BackContinueType the names of all children and parents down below. These waivers that you will sign include participants and their household members. Any additional visitors will need to complete a waiver before entering premises. Liability Release CJE 4.7.19.pdf Parent/Guardian A: I have read and accepted the terms of this liability waiver (will be required to sign physical copy on site). I certify that I understand and accept the risk and will not hold Compton Jr.. Equestrians liable as stated on the document. I agree that this fill will be used in place of a physical signature and holds the same requirements and acknowledgements. * Clear Signature Parent/Guardian B: I have read and accepted the terms of this liability waiver (will be required to sign physical copy on site). I certify that I understand and accept the risk and will not hold Compton Jr.. Equestrians liable as stated on the document. I agree that this fill will be used in place of a physical signature and holds the same requirements and acknowledgements. Clear Signature COVID liability CJE.pdf Parent/Guardian A: I have read and acceptedthe terms of this COVID liability waiver. I certify that I understand and accept the risk and will not hold Compton Jr.. Equestrians liable as stated on this document. I agree that this fill will be used in place of a physical signature and holds the same requirements and acknowledgements. * Clear Signature Parent/Guardian B: I have read and acceptedthe terms of this COVID liability waiver. I certify that I understand and accept the risk and will not hold Compton Jr.. Equestrians liable as stated on this document. I agree that this fill will be used in place of a physical signature and holds the same requirements and acknowledgements. Clear Signature Photo Release.pdf Parent/Guardian A: Photo Release * Clear Signature Parent/Guardian B: Photo Release Clear Signature Checkboxes *I understand that CJE/CC is constantly fiIming and I agree to have my child's images/videos posted on the CJE and associated wesbites and social mediaCheckboxes *I agree to provide student report cards and other material to CJE to track my child's progressBackContinuePlease provide your name, signature and date to certify that all the information is correct. Parent/Guardian Name *Parent/Guardian Signature * Clear Signature Date *Student Name *Student Signature * Clear Signature Date *Parent/Guardian ID + * Drag & Drop Files, Choose Files to Upload Upload supported file (Max 15MB)Report Card Child 1 Drag & Drop Files, Choose Files to Upload Upload supported file (Max 15MB)Report card child 2 (if applicable) Drag & Drop Files, Choose Files to Upload Upload supported file (Max 15MB)Report card child 3 (if applicable) Drag & Drop Files, Choose Files to Upload Upload supported file (Max 15MB)Proof of income if applying for reduced rate (w2, check stub, govermental assistance documentation) Drag & Drop Files, Choose Files to Upload Upload supported file (Max 15MB)Submit
