COVID-19 Agreement Form

By typing your name below, you agree that you have read this statement: I acknowledge that I have voluntarily signed my child up for Achieve Learning Center's programming. I understand that there will be no more than 5 students present in the learning center at any given time. I agree to follow Achieve Learning Center's safety and screening procedures and encourage healthy habits at home. I absolve Achieve Learning Center and its staff of all responsibility should my child, myself or another family member contract COVID-19.

COVID-19 Agreement Form

* Indicates required field

Student Name *

First

Last

Parent/Guardian Name *

First

Last

Email *

By typing your name below, you agree that you have read this statement: I acknowledge that I have voluntarily signed my child up for Achieve Learning Center's programming. I understand that there will be no more than 5 students present in the learning center at any given time. I agree to follow Achieve Learning Center's safety and screening procedures and encourage healthy habits at home. I absolve Achieve Learning Center and its staff of all responsibility should my child, myself or another family member contract COVID-19. *

I agree to receiving marketing and promotional materials

Submit

All parents who will be brining their children to Achieve Learning Center after March 20, 2020 must fill out the form below. Before filling out this form be sure you have read and agree with all statements.

COVID-19 Agreement Form