Classes Start September 9th, 2024 Classes meet 1 day each week in the Cross Academy home at: 7816 147th St E Puyallup, 98375. Payment options available. A wait-list will be started once a class is filled. Please use the form below to register your student. If you prefer, you can download the paper version and mail in your registration. Hands-on Science A & C, General Science, Life Science, & Biology are FULL Please contact Mrs. Cross to be placed on the waiting list Student InformationStudent Name(Required) First Last Student Age(Required) Student Date of Birth(Required) MM slash DD slash YYYY Student Gender(Required)Select OneMaleFemaleStudent Grade(Required)Select One2nd3rd4th5th6th7th8th9th10th11th12thStudent Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Student Email(optional) Student Mobile Phone(optional) HiddenStudent Mobile Phone(optional)Parent/Guardian InformationParent #1(Required) First Last Parent #2 First Last Parent #1 Email(Required) Parent #2 Email HiddenParent #1 PhoneHiddenParent #2 PhoneParent #1 Phone(Required) Parent #2 Phone Emergency ContactEmergency Contact Name(Required) First Last Emergency Contact Phone(Required) Emergency Contact Relationship(Required) HiddenEmergency Contact Phone(Required)Confidential Medical/Emergency InfoPlease indicate information about the student regarding medications, allergies, physical/mental/learning disabilities, or restrictions that the instructor should know about prior to class.Medical Emergency Consent(Required) I agree In case of emergency, I give my permission to have my child receive first aid and be transported to the nearest hospital by professional emergency personnel. I understand I will be financially responsible for the cost of such treatment.Signature (Medical Emergency Consent)(Required)Use your mouse or finger to sign your namePhoto/Video Consent I agree I give Cross Academy permission to use any photographs or video footage of my child for purpose of illustration, broadcast, internet web production or any other distribution in any manner.Signature (Photo/Video Consent)Use your mouse or finger to sign your name2024-25 Class SelectionPlease select the class for your student. Class List and Descriptions (opens in a new tab) Classes start the week of Sept 9th 2024Class Selection(Required)Select OneElementary ScienceLife ScienceGeneral SciencePhysical ScienceBiologyChemistryElementary Science day/time?(Required) A - Mondays 9-11 AM B - Mondays 12-2PM C -Tuesdays 12-2PM Hands on Science C is FULL Please contact Mrs. Cross to be placed on the waiting listHands on Science B is FULL Please contact Mrs. Cross to be placed on the waiting listHands on Science A is FULL Please contact Mrs. Cross to be placed on the waiting listHands-On Elementary Science(Required)If you choose to pay a deposit only, the balance is due August 1st.Select OnePay in Full ($295 + $75 lab fee)Non-Refundable Deposit/Lab fee ($75) Life Science is FULL Please contact Mrs. Cross to be placed on the waiting list HiddenLife Science(Required)If you choose to pay a deposit only, the balance is due August 1st.Select OnePay in Full ($395 + $95 lab fee)Non-Refundable Deposit/Lab fee ($95)General Science is FULL Please contact Mrs. Cross to be placed on the waiting listHiddenGeneral Science(Required)If you choose to pay a deposit only, the balance is due August 1st.Select OnePay in Full ($395 + $95 lab fee)Non-Refundable Deposit/Lab fee ($95)Physical Science(Required)If you choose to pay a deposit only, the balance is due August 1st.Select OnePay in Full ($395 + $95 lab fee)Non-Refundable Deposit/Lab fee ($95)Biology is FULL Please contact Mrs. Cross to be placed on the waiting listHiddenBiology(Required)If you choose to pay a deposit only, the balance is due August 1st.Select OnePay in Full ($395 + $95 lab fee)Non-Refundable Deposit/Lab fee ($95)Chemistry(Required)If you choose to pay a deposit only, the balance is due August 1st.Select OnePay in Full ($395 + $95 lab fee)Non-Refundable Deposit/Lab fee ($95)Class Fees Total Cross Academy Swag?Would you like to buy a Cross Academy Tee or Hoodie?(Required) Yes No Cross Academy Tee None $20 KID Small $20 KID Medium $20 KID Large $20 KID XL $20 ADULT Small $20 ADULT Medium $20 ADULT Large $20 ADULT XL $20 ADULT 2XL Cross Academy Hoodie None $45 ADULT Small $45 ADULT Medium $45 ADULT Large $45 ADULT XL $45 ADULT 2XL How did you hear about Cross Academy? How would you like to pay?(Required) Credit Card PayPal Credit CardCard Details Cardholder Name Total When you click the "SUBMIT" button, you will be redirected to PayPal.
