FLORIDA REGION STUDENT ACTIVITIES REGISTRATION

Transcription

1 FLORIDA REGION STUDENT ACTIVITIES REGISTRATION SCHOOL: ADDRESS: CITY:_ STATE: ZIP: PHONE: ( ) FAX: ( ) STUDENT ACTIVITIES COORDINATOR: COORDINATOR S *SCREENING REQUIREMENTS* By registering for these events you are agreeing to ensure that all staff and volunteers the school provides meet the school s internal policies and standards as well as state requirements for working with children in a K-12 private school setting. Signature: Title: Date: (Please note: This section must be signed by the Head of School or Principal) Registration: August 3, 2015 until November 2, 2015 $55.00 per event (Check) $58.00 (Credit Card) No registrations will be accepted after November 2, Registrations will be handled in the order in which they are received. Be sure to register early to ensure a space for your school. Enrollment is limited for many activities! Payment must accompany this registration form. Please send school checks made out to ACSI or credit card payment. NO REFUNDS WILL BE GIVEN IF YOUR SCHOOL CANCELS!! THIS AREA FOR ACSI OFFICE USE ONLY: Date confirmation sent Closed event: Date refund sent Total events Host school Payment Amount Date rcd. 1

2 Please place a check next to the activities you plan to attend and list your school's coordinator AND their address. Location Date Grades ART FESTIVALS Clearwater Community Church, Dunedin Mar. 3 K-5 Clearwater Community Church, Dunedin Mar Park Avenue Christian Academy, Titusville Mar. 4 K-12 Jupiter Christian School, Jupiter April 29 K-12 Your school's art festival coordinator: CREATIVE WRITING FESTIVALS Note: Students not do attend this event. Only the entries are sent to the host site for judging. Orangewood Christian School, Maitland Mar Westlake Christian School, Palm Harbor Apr ACSI Florida Regional Office, Dunedin Apr Community Christian School, Port Charlotte Apr First Baptist Academy, Naples Apr Your school s creative writing coordinator: MATH OLYMPICS *Availability is limited for these events in RED. Call the ACSI Florida Regional Office at to check for availability before registering for this event EXCEPT if you are hosting this event. Coral Springs Christian Academy, Coral Springs Mar Potential Christian Academy, Cooper City 1555 Mar Merritt Island Christian School, Merritt Island Mar Rocky Bayou Christian School, Niceville Apr Clearwater Community Church, Dunedin Apr Southwest Florida Christian Academy, Ft. Myers Apr University Christian School, Jacksonville Apr Foundation Academy, Winter Garden Apr Northside Christian School, St. Petersburg Apr Your school's math olympics coordinator:_ MUSIC FESTIVALS (Elementary/Middle School Vocal) Indian Rocks Christian School, Largo Mar Coral Springs Christian Academy, Coral Springs Mar Your school's elementary choir coordinator: 2

3 Location Date Grades MUSIC FESTIVALS (Middle/High School Vocal) Indian Rocks Christian School, Largo Mar Your school's secondary choir coordinator: MUSIC FESTIVALS (Instrumental Concert Band) Skycrest Christian School, Clearwater Mar Your school s instrumental music coordinator: MUSIC FESTIVALS (Instrumental Solo/Ensemble) Westlake Christian School, Palm Harbor Apr Calvary Christian Academy, Ft. Lauderdale May Your school s instrumental music coordinator: MUSIC FESTIVALS (Piano) Keswick Christian School, St. Petersburg Mar Ocala Christian Academy, Ocala Apr Your school's piano festival coordinator: SCIENCE FAIRS Orangewood Christian School, Maitland Mar Bethany Christian School, Ft. Lauderdale Apr Your school's science fair coordinator: SPEECH MEETS (Elementary) Northwest Christian Academy, Miami Feb Bell Shoals Baptist Academy, Brandon Mar _ 3

4 SPEECH MEETS (Middle School) Location Date Grades Westlake Christian School, Palm Harbor Feb Northwest Christian Academy, Miami Feb _ SPEECH MEETS (Senior High) Northwest Christian Academy, Miami Feb _ SPELLING BEES (Grades 1-4) Merritt Island Christian School, Merritt Island Feb Coral Springs Christian Academy, Coral Springs Feb Southwest Florida Christian Academy, Ft. Myers Feb Aletheia Christian Academy, Pensacola Feb Westlake Christian School, Palm Harbor Feb Sheridan Hills Christian School, Hollywood Mar Foundation Academy, Winter Garden Mar Trinity Christian School, Palm Beach Gardens Mar First Christian Academy, New Port Richey Mar Promise Land Academy, Jacksonville Mar Your school's grades 1-4 spelling coordinator: SPELLING BEES (Grades 5-8) Sheridan Hills Christian School, Hollywood Feb Promise Land Academy, Jacksonville Feb Real Life Christian Academy, Clermont Feb Boca Raton Christian School, Boca Raton Feb Westlake Christian School, Palm Harbor Feb Aletheia Christian Academy, Pensacola Feb Central Baptist Christian School, Brandon Feb Community Christian School, Port Charlotte Feb Merritt Island Christian School, Merritt Island Feb Your school's grades 5-8 spelling coordinator: 4

5 NUMBER OF EVENTS ATTENDING: Minus TOTAL NUMBER OF ACTIVITIES HOSTING: TOTAL NUMBER OF ACTIVITIES: REGISTRATION FEES: TOTAL AMOUNT TO BE PAID: X $ (Check) OR X $ (Credit Card) $ Credit Card Information: Visa MasterCard #: Expiration Date: 3 Digit Security Code: Name on card: _ Checks for the full amount, made out to ACSI, or credit card payments with the applicable processing fee must accompany this form. NO REFUNDS will be given if your school cancels, so please plan carefully. If your school is hosting an activity, no registration fee ($55.00) will be required; however, your school still needs to register for the activity, AND the participation fee(s) will be due on or before the participation deadline. SCHOOL ACCIDENT INSURANCE REQUIREMENT All schools participating in an event with the Association of Christian Schools International should ensure that they have adequate insurance coverage for students and sponsors/teachers. ACSI does not assume responsibility for these coverages. The school s student accident insurance should cover most reasonable and customary medical expenses. Worker s compensation coverage should cover employees/teachers. Activities include, but are not limited to: art, cheerleading, math, music, science, speech, and spelling events. PLEASE SEND THIS FORM AND CHECK OR CREDIT CARD INFORMATION TO: ACSI-FLORIDA, 461 PLAZA DRIVE, SUITE C, DUNEDIN, FLORIDA Phone: (727) Fax: (727)