Skip to content
Main Menu
Login
Parent / Student / Tutor
Register
Parent / Student Signup
Tutor Signup
My Account
Main Menu
Home
Online Courses
After School
Camps
Music
Confident Speakers
Shop
Meet Our Team
About Us
Welcome
The School Day
Policies
Contact
Cart
$
0.00
0
0
Subtotal:
$
0.00
No products in the basket.
No products in the basket.
Continue Shopping
Flyout Menu
Home
Online Courses
After School
Camps
Music
Confident Speakers
Shop
Meet Our Team
About Us
Welcome
The School Day
Policies
Contact
Login/Register
Application Form
Windjammer Plaza, 461 Walkers Road, George Town, Grand Cayman
Email: info@ascendtechacademy.com
Phone: +1 (345) 326-2882
Website: https://ascendtechacademy.com
Personal Details
Firstname:
Lastname:
Date of Birth:
Gender:
Male
Female
Other
Address:
District:
Select from option below:
Bodden Town
East End
George Town
North Side
West Bay
PO Box and PostCode
Nationality:
Primary Language Spoken at Home:
Schools Attended:
Years attended:
.
Schools Attended:
Years attended:
.
Schools Attended:
Years attended:
.
PARENT AND GUARDIAN INFORMATION
Primary Guardian:
Firstname:
Lastname:
Relationship to Student:
Plesae select from list below:
Parent
Guardian
Sibling
Other
Please provide more information if other:
Phone Number:
E-mail address:
Secondary Guardian (if applicable):
Firstname:
Lastname:
Relationship to Student:
Plesae select from list below:
Parent
Guardian
Sibling
Other
Please provide more information if other:
Phone Number:
E-mail address:
Does the student have any allergies?
Yes
No
If yes, please specify:
Does the student have any medical conditions?
Yes
No
If yes, please specify:
If yes, please specify:
MEDICAL AND HEALTH INFORMATION
Primary Doctor’s Name:
Doctors Contact Number:
Does the student have any medical conditions?
Yes
No
If yes, please specify:
Heath Insurance Provider (if applicable):
Policy Number:
EMERGENCY CONTACT INFORMATION (if different from parent/guardian information)
Emergency Contact Name:
Relationship to Student:
Phone Number:
EMERGENCY CONSENT
I, the undersigned parent/guardian of the above-named student, hereby give permission for Ascend Tech Academy Ltd. to seek medical attention for my child in the event of an emergency. I understand that reasonable efforts will be made to contact me before initiating medical care. However, if I cannot be reached, I consent to my child receiving emergency medical treatment as deemed necessary by qualified medical personnel.
Parent / Guardian Signature:
Date
CONSENT & AGREEMENT
Policy Agreement
I understand and agree to the policies of Ascend Tech Academy Ltd.
Accurate data
I confirm that the information provided in this form is accurate and up-to-date.
Activities Consent
I consent to my child's participation in Ascend Tech Academy activities.
Unsupervised Risk
I understand the risks associated with unsupervised one-on-one situations with children and adults.
Photographs Consent
I give permission for photographs and videos of my child may be taken during activities and can be used for promotional purposes.
Photos and video consent
Yes
No
Parent/Guardian Signature:
Date
Send
Scroll to Top
