Registration

In case of Emergency

ALPHA LEADERSHIP ACADEMY INC
STUDENT ADMISSIONS APPLICATION


STUDENT RESIDES WITH ADULT LISTED IMMEDIATELY BELOW:

ADDITIONAL ADULT INFORMATION



    I agree to the terms listed above

Electronic Signatures. By checking this box, I/we agree that my electronic signature to this Agreement/Application shall be as valid as an original signature of such party and shall be effective to bind such party to this Agreement/Application. The parties agree that any electronically signed document (including this Agreement/application) shall be deemed (i) to be “written” or “in writing,” (ii) to have been signed and (iii) to constitute a record established and maintained in the ordinary course of business and an original written record when printed from electronic files. Such paper copies or “printouts,” if introduced as evidence in any judicial, arbitral, mediation or administrative proceeding, will be admissible as between the parties to the same extent and under the same conditions as other original business records created and maintained in documentary form. Neither party shall contest the admissibility of true and accurate copies of electronically signed documents on the basis of the best evidence rule or as not satisfying the business records exception to the hearsay rule. For purposes hereof, “electronic signature” means a manually-signed original signature that is then transmitted by electronic means; “transmitted by electronic means” means sent in the form of a facsimile or sent via the internet as a “pdf” (portable document format) or other replicating image attached to an e-mail message; and, “electronically signed document” means a document transmitted by electronic means and containing, or to which there is affixed, an electronic signature.

Alpha Leadership Academy Inc.

Parent/Guardian Consent
To Photograph, Filim, or Videotape a student for Non-Profit Use

I hereby consent to the participation in interviews,the use of quotes, and the taking of photographs, movies or videotapes by Alpha Leadership Academy Inc and its Staff.

I also grant consent to the right to edit, use and reuse said products for non-profit purposes including use in print, on the internet, and all other forms of media.

I also hereby release the Alpha Leadership Academy Inc, and its agents and employees from all claims, demands and liabilities whatsoever in connection with the above.

By signing below, I certify by consent to photograph, filim or videotape this student for non-profit media use.

Alpha Leadership Academy Inc.

Windsor Nelson
Founder & President

Student Field Trips
Parental Consent Form

While under appropriate, pedagogical and administrative supervision, its may be necessary at times, for my child to leave

 and travel to sites within close proximity of the building, for such excursions students will

be traveling to and from the specified location. Therefore, I am granting permission for my child  

to leave the ground of

  

 during the duration of his/her time at Alpha Leadership Academy Inc

when necessary.

    I agree to the terms listed above

Electronic Signatures. By checking this box, I/we agree that my electronic signature to this Agreement/Application shall be as valid as an original signature of such party and shall be effective to bind such party to this Agreement/Application. The parties agree that any electronically signed document (including this Agreement/application) shall be deemed (i) to be “written” or “in writing,” (ii) to have been signed and (iii) to constitute a record established and maintained in the ordinary course of business and an original written record when printed from electronic files. Such paper copies or “printouts,” if introduced as evidence in any judicial, arbitral, mediation or administrative proceeding, will be admissible as between the parties to the same extent and under the same conditions as other original business records created and maintained in documentary form. Neither party shall contest the admissibility of true and accurate copies of electronically signed documents on the basis of the best evidence rule or as not satisfying the business records exception to the hearsay rule. For purposes hereof, “electronic signature” means a manually-signed original signature that is then transmitted by electronic means; “transmitted by electronic means” means sent in the form of a facsimile or sent via the internet as a “pdf” (portable document format) or other replicating image attached to an e-mail message; and, “electronically signed document” means a document transmitted by electronic means and containing, or to which there is affixed, an electronic signature.

This document is to be returned to and retained by by the school.