New Cta Contract For Families

Cornerstone Tutorial Academy
Home School Tutorial
Handbook & Registration Packet 2015-2016 School Year

*****PLEASE READ ALL PAGES CAREFULLY*****
Pages 1-8 CTA Handbook
Pages 9-15 Application/Registration Packet

Page 1
Index
Page 2
Mission Statement, Statement of Faith, & Application Instructions
Page 3
Academic Program Overview of Fees, Registration, & Parental Duties
Page4
Clean-up Hours, Open Policy, Teacher Substitutes, Dress Code, & General Classroom Rules
Page 5
General Outside Rules & General Behavior Rules
Page 6
Discipline Policy, Illness Policy, & Weather Policy
Page 7
Lunch Policy, Directors Contact Info., Classes & Electives
Page8
Tuition & Payment Schedule
Page 9
Application
Page 10
Financial Agreement
Page 11
CLASSES/SPORTS/SOCIAL/LUNCH WAIVER
Page12 & 13
2 Page Driver Release Form
Page 14
STATEMENT THAT YOU HAVE READ AND AGREED WITH ALL SECTIONS INCLUDED
IN THE REGISTRATION PACKET
Page 15
Student Inventory
Page 16
(Family Registration Worksheet)
1
Copyright 2015 Cornerstone Tutorial Academy. All Rights Reserved.

MISSION
The Cornerstone Tutorial Academy was founded in 2014 as a means to provide homeschooling children in and around the Rutherford County area a set of classes:
1 That is conveniently close, affordable, and Non-Denominational.
2 That offers extra support to our families through multiple days.
3 That encourages the development of lasting friendships.
4 That inspires creativity and individuality.
5 That offers highly qualified Degreed Christian Teachers.
6 That provides enriching academics and guidance to the childs home education.
The program is open to all home-schooling families in the community, regardless of
religious affiliation.
STATEMENT OF FAITH
The Bible is God's infallible word that reveals God's will and purpose for mankind
Every word in the Bible is inspired by God and is the ultimate authority for living a
fulfilled life
There is only one God who has revealed Himself in three persons- the Father, the Son
(Jesus Christ), and the Holy Spirit
God is the Creator and in control of all things
Jesus Christ is the Son of God, born of a virgin, sinless and perfect
Jesus taught the truth and demonstrated the power of God in miracles
Jesus died on a cross to atone for man's sins, rose from the dead and ascended into heaven
By His death and resurrection, Jesus has cleansed from sin those who repent of their sins
and believe that Jesus is Lord and Savior After salvation, a relationship with the Father is
restored through faith in Jesus Christ his Son, faith increases and an abundant life filled
with the fruit of the Spirit follows
The Holy Spirit indwells the believer and gives the enabling power of God to live a holy life,
to overcome sin, to understand the Bible and to do the will of God
Application Instructions
To insure that you get the classes that you want, you must turn in your family application and class
request forms as soon as possible. Priority for enrollment is given as follows:
Current CTA families have priority for class selection followed by siblings of current families.
Class selections received from current families after Feb. 27th, 2015 will not have priority over new
family registrations already submitted.
For all optional 2 day classes offered Priority will be given to those signing up for the 2 day option
for those subjects.
Please prayerfully consider whether your familys educational needs would be met at
Cornerstone Tutorial Academy.
Family Interview - When your application is received and reviewed, you will be contacted to
Set up a family interview.
At registration - you will get a copy of your student class schedule and information about the
teacher, the class, and the information you need to purchase the required books and materials
for that class. It may also have a summer reading list from your teacher so please be sure to
look.
2

Academic Program
CTA's enriching academic program meets on Tuesdays, Wednesdays, and Thursdays. (This depends on
which Classes you Choose). This program offers various enriching academic classes taught by highly
qualified teachers. CTA utilizes Curriculum, nature, hands-on, and literature-based, as well as small
student-teacher ratios, for individualized learning. Parents are the first and foremost teachers of their
children at a homeschooling academy. While attending CTA, teachers and parents exist as co-teachers.
Communication between parents and teachers is facilitated through weekly emails, class syllabi, and
parent teacher conferences as needed throughout the year. You will be expected to follow the class
assignments at home and complete all assignments in a timely manner. Classes at CTA are classes to help
prepare your child for a College path or a Technical Path. Our classes will help teach each student
organizational skills, study skills, and how to accept responsibility as the approach their young adult life.
Classes have no more than 12 students. The program runs for 30 weeks for Middle through High School.
Assembly
Meets at 8:15-8:25 A Praise Song, A Bible Verse read, Pledge of Allegiance, & Prayer is offered before
classes begin.
Fees
All fees, which cover Initial Registration and Supply Fees, are due at registration to guarantee your spot.
A payment plan is offered over 10 payments from July to April with payments being due on or before the
1st day of the month. Checks are postdated for July 1, Aug. 1, Sept. 1, Oct. 1, Nov. 1, Dec. 1, Jan. 1, Feb.
1, Mar. 1, and Apr. 1, for the 2015-2016 school years. The monthly amount will NOT change for short
months. A late fee of $25.00 will be assessed for all returned checks.
The Enrollment Fee is non-refundable. If you decide to withdraw your child at any time during the year, a
full year of tuition will be due, so please make a commitment for the year when you register for a class.
Registration
First step is to email the Cornerstone Tutorial Academy Director, Pamela Brown at
cornerstonetutorialacademy@gmail.com to get an application emailed to you. Email the application back
to cornerstonetutorialacademy@gmail.com . A visit will be set up and then the application fee is due. This
is when you will pick the classes your child wishes to attend.
At Registration you will pay all other fees if you wish to attend CTA. We must receive the fees before
your students spot will be held. Checks are written to each Tutor for the Tuition and Supply Fees. Checks
are written to Cornerstone Tutorial Academy for Administration and Registration Fees.
Note: If your child is not picked up or being supervised by a designated adult 15 minutes after
classes let out, a $1.00/minute fee will be assessed after that 15 minutes. Please do not be late. There
will be no supervision in the mornings.
Failure to pay Fees and/or Tuition will result in immediate dismissal from CTA
Parents Duties
Parents are expected to be a part of the CTA Engrade and must have an Email account since most
communication from teachers and the academy will be done via Engrade and/or Email.
Parents are expected to support and facilitate their childs learning through the academy by supporting
and helping with any homework assignments and/or rehearsals or performances held in addition to the
school day. Parents are expected to help their children understand all rules, behavior guidelines, etc. at
CTA. After school, when parents arrive, they are responsible for their child. Please make sure your child
is being supervised and following the rules at CTA.
3

Clean-up Hours
Clean-up volunteer hours will be required of each student and parent to help keep the school clean.
This will teach the students that they have an active role in keeping their schoolhouse clean so they will
be better aware of making a mess.
The clean-up time will be from 3:00 to 3:30 after school each day. Students will be assigned each day
to clean their classroom and other areas. 4 parents will volunteer each day to monitor the clean-up time
from 3:00-3:30. Inside duties include cleaning tables, floors, sinks, and trash. The parent monitors will be
expected to rub down toilets, sinks, and doorknobs.
Open Policy
At CTA, we believe that offering the best environment for children requires a team effort between
director, teacher and parents. Parents should feel welcome to address any issues or concerns with the
Director. This can be done via telephone, E-mail, in person, or at a requested meeting.
Teacher Subs
We need several parents to sign up for teacher subs to be called on when a teacher must be absent due to
an emergency or pre-planned event. Subs will be paid $20.00 per class (or agreed on privately through
teacher) and will be given an outline of what to do with the class. If interested, please let the director
know and fill out the Teacher Sub application. Teacher Subs will be required to have a background check.
Dress Code
All participants (volunteers, students, and teachers or subs) at CTA are expected to dress modestly and
respectfully during school hours. Shoes are required to be worn inside and outside.
CTA reserves the right to make final determination of what dress is considered inappropriate.
General Classroom Rules
1 Use indoor voices.
2 Student must stay in their classroom during class unless needing to be excused for illness, Dr.
Appointment, or Restroom break, (even if their parent is working or volunteering that day).
Otherwise, if they leave the classroom they will not be allowed to return to that class on that day.
They will be sent to study hall and a fee will be incurred at $5.00. At the end of said class the
student will be allowed to participate in their next class. 3 offenses in the same class then the
student will be dropped from the class and not allowed to participate in the said class. The only
other exception to this would be if your child has a medical condition that needs consideration. If
this is the case then you must let the Director and the Teacher know at registration. Please supply
a Doctors note stating the special need of your child.
3 No running indoors & No horse playing.
4 Treat the property as you would your own. Absolutely no writing, picking or tearing on walls,
floors, furniture or fixtures.
5 Absolutely no excess toilet paper, no paper towels, etc. should be put into the toilets.
6 Wash your hands after using the bathroom.
7 Clean up after yourself.
8 Make sure your trash and paper go into the trash can.
4

General Outside Rules
1 No climbing over fences or up trees.
2 No throwing mulch, dirt, granite, or rocks.
3 No lunch or food on the playground/outside grounds.
4 Do not litter and please pick up any trash you see and put in the trashcans.
5 Stay in the boundaries during any possible recess time.
6 Put back what you get out.
General Behavior Rules

1 Students are expected to participate in class discussions, labs, and whatever the teacher
requests of you.
2 Students are expected to complete all homework assignments.
3 Students are expected to be respectful of school property.
4 No toys & No electronics. All cell phones should not be out unless an emergency to call
parent. Otherwise, they will be taken away and held in the office until a parent comes to
recover it after school.
5 No outside food or drink is allowed in the classroom unless brought by the teacher of
that class or approved by the director.
6 No smoking, alcoholic beverages or illegal drugs are allowed.
7 Label all supplies, backpacks, lunch boxes, coats, etc.
8 No Throwing things, Pushing, Kicking, Hitting, Sword-Fighting, Profanity, Teasing,
Targeting, Bullying, or disrespectful behavior is allowed.
9 No weapons (play or real), knives, or any other item that could lead to danger or
disruption.
10 If any item causes disruption, it will be taken up by the teacher or director and the
Parent must recover it.
11 All students should be in class at all times or accounted for by their teacher during class
hours.
12 Be sure to leave all areas neater than you found them.
13 Any accidents should be reported immediately to available assistant or director
14 Remind your student that if there are any issues with another child they must report to a
teacher immediately. The only way we or a teacher can handle altercations that may
involve he said/she said is to observe it or be notified immediately.
15 If you have a student with special needs, please notify director and/or teachers before
classes begin. Special needs include food allergies, asthma, or slow start reader.
16 Be aware that we are not professionally equipped to handle children with severe
special needs and/or behavior problems.
17 Students are expected to be in their classes on time. Late arrivals disrupt class.
18 Students are expected to treat everyone with kindness.
19 Students are expected to clean up after themselves.
20 Students are expected to respect others property and each other.
5

Discipline Policy
1 The school supports positive discipline. Our teachers are experienced in classroom management
so that behavior problems are not usually an issue.
2 Forms of discipline may include redirection, corrections, warnings, work assignments, or
dismissal.
3 If redirection is not working, a warning and correction/move the student to another seat will be
given first in most instances.
4 Parents will be informed of the situation if a warning and correction do not correct the behavior.
5 If necessary, a student may be sent out of class and parents called to come pick them up. This is
only done if redirection, warning, and/or correction will not correct the behavior.
6 At the discretion of the academy, some offenses can result in immediate dismissal from the
academy, and tuition will not be refunded.
7 All situations will be handled on a case-by-case basis.
8 The student and parent must accept any discipline measures with a good attitude or be dismissed
from the academy without a refund.
9 Everyone is expected to cooperate to maintain the integrity of our program.
10 If a student or parent has a problem or concern about another student, parent, or teacher, this must
be addressed with a teacher and director immediately so that steps can be made to alleviate the
concern. Problems cannot be fixed if the teacher and director are unaware that a problem exists.
11 CTA has an anti-bullying policy. Bullying may be defined as the activity of repeated, aggressive
behavior intended to hurt another person, physically or mentally. We do not use the term bullying
lightly. Teachers, assistants, director, and parent helpers strive to keep CTA a safe and fun place
for each and every child. We always want to be made aware of any aggressive behavior
immediately so we can address it. There are many times children have disagreements or may do
something mean in retaliation or because they feel hurt, un-included, or taken advantage of. We
always strive to correct this by talking with each student and giving helpful ways to resolve
conflict. However, adults dont always catch or see subtleties. This is why it is so important for a
student to let a teacher or adult know immediately if they feel they are being treated wrong.
Please encourage your children to speak out to any adult at CTA if they feel they are being
wrongly treated. This will help CTA stop any type of bullying behavior before it begins. Any
child who is bullying will be asked to leave immediately and tuition will still be non-refundable.
Illness Policy
Do not bring students to CTA if they have had Staph, Strep, Flu, diarrhea, vomiting, fever, lice, pink eye,
or other contagious conditions in the last 24 hours. They should be treated if they have lice and all nits
removed before returning to school. Parents should request make up work from the teacher and work with
the child at home to insure they are caught up. CTA has the right to not allow a child at school if felt the
child is carrying something contagious. CTA has the right to call a parent to come pick up their child at
any time if CTA feels the child is contagious or too ill to remain in class.
Weather Policy
CTA will be following Rutherford County School System as far as weather cancellations or delays. If the
Rutherford County School System is delayed, CTA will start at the same time the Rutherford County
School System starts unless otherwise notified. If Rutherford County School System is cancelled, CTA
will be cancelled as well. If there is an emergency such as flooding, sickness, toilets not working properly,
etc., we will be closed.
6

Lunch Policy
All students may bring a water bottle marked with their name on it for the school day.
All students must bring their lunch marked with their name. We do not provide Utensils or napkins.
Lunches and snacks may only be eaten in the designated lunch areas at the designated time.
Chewing gum in not permitted.
Directors Contact Info (Pamela Brown) cornerstonetutorialacademy@gmail.com
Proposed Classes and electives this offer depends on Teachers & meeting the minimum number
of students for the class.
Math Dept.
High School = Pre-Algebra, Algebra 1, Algebra 2, Geometry, Pre-Cal/Trig, Calculus, &
Statistics
Middle School = Saxon 6/5 or Teaching Textbooks 6, Middle Saxon 7/6 or Teaching
Textbooks 7, Saxon 8/7 or Teaching Textbooks Pre-Algebra
Lang. Arts Dept.
High School= IEW C & World Literature, IEW Student Intensive Continuation Course
Level C & American Literature, IEW Speech Boot Camp & Classic Literature, & IEW
Advanced Communication Series & English Literature,
Middle School =IEW A, IEW B, & IEW Student Writing Intensive Continuation Course
Level B,
Science Dept.
High School= With Labs=Exploring Biology 2nd edition, Exploring Creation with
Chemistry, Exploring Marine Biology, Exploring Creation with Physics,
Middle School = Exploring Creation with Chemistry and Physics, Apologia General
Science, Apologia Physical Science
Social Studies Dept.
High School= World Geography, U.S. History, Government & Economics, Personal
Finance / 1 Semester,
Health 1/ Semester, Study Skills 1/ Semester, & Philosophy & Christian World View
Foreign Lang. Dept.
French 1
Spanish 1
Spanish 2
Latin
Sign Language
Electives
Basic Art
Advanced Art
Photography
Computer Programming
Computer Game Design
Voice
7
CORNERSTONE TUTORIAL ACADEMY

(30 WEEK TUTORIAL) August 10, 2015-April 29, 2016
Our "TUITION RATES DECREASE" with each Student added past the
minimum per class
(You may choose between the following minimum # of students you are interested
in joining at, the 3 student, 4 student, or 5 student minimum rates).
TUITION FOR 1 DAY ONLY SUBJECTS THAT ARE 1 HOUR CLASSES
(Approximate Rate Range = $7.67 to $4.17 per hour per class)
Per Subject Tuition by # of Stu. 3 = $230. / 4 = $172. / 5 =$160. / 6 =$146. / 7
=$144. /8 = $142. /---------- 9 = $142. / 10 = $141. / 11 = $131. / 12 = $125.
TUITION FOR 2 HOUR CLASSES OR 2 DAY CLASSES THAT ARE 1 HOUR EACH
DAY (Approximate Rate Range = $7.67 to $4.17 per hour per class)
Per Subject Tuition by # of Stu. 3 = $460. / 4 = $344. /5 =$320. /6 =$292. /7 =
$288. / 8 = $284. /--------- 9 = $284. / 10 = $282. / 11 = $262. / 12 = $250.
TUITION FOR 1 DAY ONLY SUBJECTS THAT ARE 1 & 1/2 HOUR CLASSES
(Approximate Rate Range = $7.67 to $4.17 per hour per class)
Per Subject Tuition by # of Stu. 3 = $344. / 4 = $258. / 5 =$240. /6 =$220. /7 =
$216. / 8 = $214. / ---------9 = $214. / 10 = $212. / 11 = $197. / 12 = $188.
TUITION FOR 2 DAY CLASSES THAT ARE 1 & 1/2 HOUR EACH DAY (Rate
Range = $7.67 to $4.17 per hour per class)
Per Subject Tuition by # of Stu. 3 = $688. / 4 = $516. /5 =$480. /6 =$440. /7 =
$432. / 8 = $428. /----------- 9 = $428. / 10 = $424. / 11 = $394. / 12 = $376.
***Supply Fee per subject*** 1 Day Class for Sciences, Arts, & other Electives =
$30.,***Supply Fee for each 2 Day Science class = $40.,***NO Supply Fees on 1 or 2
Day, Lang. Arts, Math, History, Civics, Geography, & Foreign Lang.
EACH STUDENT WILL FURNISH THEIR CURRICULUM, NOTEBOOKS, PENCILS,
PAPER, WORKBOOKS, ETC.
Tuition Checks will be made out to each Tutor/Teacher at Registration
Payment options are as follows:
10 Pymts. dated *July 1, *Aug. 1, *Sep. 1, *Oct. 1, *Nov. 1, *Dec. 1, *Jan. 1,
*Feb. 1, *Mar. 1, *Apr. 1,
8 Payments dated
1, *Apr. 1
*Aug. 1, *Sep. 1, *Oct. 1, *Nov. 1, *Jan. 1, *Feb. 1, *Mar.
4 Payments dated
*Aug. 1, *Oct. 1, *Jan. 1, *Mar. 1
2 Payments dated
*Aug. 1, *Jan. 1
1 Payment dated
*Aug. 1
8
Cornerstone Tutorial Academy Application

Student 1 Name ___________________ Grade Level Entering _____ D.O.B. ________
Student 2 Name ___________________Grade Level Entering _____ D.O.B. ________
Student 3 Name ___________________Grade Level Entering _____ D.O.B. ________
Address _______________________________________Home Phone ____________________
Mothers Name __________________________________________________Cell _______________________
Fathers Name __________________________________________________Cell________________________
Email address ___________________________________________________
Physician and Medical Information
Physicians Name: ________________________________________
Number:________________________________
Phone
Preferred Hospital: ____________________________ Phone Number: ________________________________

List All Allergies:
______________________________________________________________________________________
Current Medicines
____________________________________________________________________________________
Over the counter Medicine Allowed to
take____________________________________________________________
Emergency Contact Information

Name (someone other than parent) ______________________Relationship _________Phone number __________
Insurance Information
Company (Carrier) name: __________________________________________________
Name of primary insured ________________________________D.O.B. of Primary insured ________
ID #_________________________________Group #___________________________
You must be registered with an umbrella organization to participate in our program. We are a tutoring facility, not
an umbrella school, and will not maintain permanent records or provide standardized testing. We do issue grade
reports for the tutoring classes every 15 weeks. It is the parent's responsibility to report all grades to the umbrella
school.
Which one has accepted your registration?
________________________________________________________________
9
Financial Agreement
Tuition can be paid in one of Five ways:

10 month, 8 month, 4 month, per semester, or 1 payment for the entire year in advance
I, ___________________________________, hereby agree to pay the tuition amount listed above, on
page 8, (per subject per student) in order for my child and/or Children, to participate in the
Cornerstone Tutorial Academy for the 2015-2016 school year. I understand that the entire tuition
amount must be paid, regardless of days my child and/or children missed due to sickness and/or
failing to complete the tutorial in its entirety. I understand that the tutorial will meet 30 weeks and
that the Tuition can be paid either on a 10 month, 8 month, 4 month, per semester, or for the entire
year in advance. If tuition will be paid monthly, I understand that I must submit post-dated checks
dated for the tuition schedule agreed to, between myself and C.T.A. These checks must be
submitted by April 1, 2015 or the day I sign these Registration papers if signing on later than April
1, 2015. I understand that checks must be made out to The C.T.A. Tutors, and I give all the Tutors
associated with the C.T.A. Tutorial permission to tutor and assist my child and/or children in
his/her educational journey. I understand C.T.A. has a zero tolerance rule for Drugs, Alcohol,
Bullying, Teasing, and/or targeting anyone at C.T.A. If in violation the student will not be allowed
to return to the C.T.A. Tutorial and the parent/guardian will not be refunded the tuition. I
understand that the entire tuition amount must be paid, regardless of my child being expelled for
any reason mentioned. The student must remain inside their Class & the building on the days they
attend the tutorial and if they leave their Class and/or building they will not be allowed to return
for the remaining classes on that day.
____ yes my Child and/or Children may be photographed for use in the Cornerstone Tutorial
Academy Newsletters, Yearbook, the Facebook page, and the Website.
____ No my Child and/or Children may not be photographed for use in the Cornerstone Tutorial
Academy Newsletters, Yearbook, the Facebook page, and the Website.
Parent signature
_________________ Date
Mother_______________________________
_________
Father _______________________________
________
10

2015-2016
CLASSES/SPORTS/SOCIAL/LUNCH WAIVER
PARTICIPANT___________________________________________
PARTICIPANT___________________________________________
PARTICIPANT___________________________________________
In consideration of your accepting our child or children for participation in the above named
program, activities and sports, I hereby, for myself, my heirs, executors, and administrators, waive
and release any and all rights and claims for damages that I may have against the above named
organization and its agents, homeowners, employees, representatives, successors and assigns for any
and all injuries suffered by myself or my child or children that rise out of the above-named
program activities and sports sponsored by the above named organization.
I warrant that I have the right to authorize the foregoing and do hereby agree to hold the abovenamed organization and its agents, homeowners, employees, representatives, successors and assigns
harmless of and from any and all liability of whatever nature which may rise out of or result from
such participation.
For the consideration stated above, I further agree that in the event that my child or I should make
any claim against the above named organization and its agents, Homeowners, employees,
representatives, successors and assigns for damages arising out of the above-named program,
activities or sports, I will personally indemnify, defend, and hold harmless the organization and its
agents, homeowners, employees, representatives, successors, and assigns against any and all loss
and damage occasioned thereby, including attorneys fees.
I have read and understand the Agreement and have willingly placed my signature below as
evidence of my acceptance of all the conditions contained herein.
Signature: Participant_______________________________Date_________
Parent/Guardian: ___________________________________Date_________
Parent/Guardian: ___________________________________Date_________
11
This form is to be filled out by the parents of the student driver

2 Page Driver Release Form (Page 12 & Page 13 of the CTA Registration Packet)
(Student Driver)
Please provide a copy of your proof of Insurance
The owner of the vehicle shall maintain liability insurance equal to or exceeding the state minimum
requirements for liability insurance.
The vehicle owners insurance is primary in the event of an accident.
The owner of the vehicle is responsible for injury or loss to any passengers because of accident.
Parents Names - Mother: _____________________Father:__________________________
Parent Address _____________________________________________________________
Parent Contact Numbers:
(Home)_______________________(Work) __________________ (Cell) ________________
Name of the Driver: #1_______________________________Driver Cell_________________
Name of the Driver: #2_______________________________Driver Cell_________________
Parents Initial and fill in the blanks.
____ (I, Mother)___________________________& (I, Father)_______________________ Give Driver
#1_____________________________ Permission to leave the school grounds during school hours.
____ (I, Mother)___________________________& (I, Father)____________________ do NOT Give
Driver #1_______________________ Permission to leave the school grounds during school hours.
____ (I, Mother)___________________________& (I, Father)_______________________ Give Driver
#2_____________________________ Permission to leave the school grounds during school hours.
____ (I, Mother)___________________________& (I, Father)______________________do NOT Give
Driver #2_______________________ Permission to leave the school grounds during school hours.
The Student Driver,_________________ is ALLOWED to drive siblings to CTA and the listed student driver may
drive away with the siblings after dismissal.
The Student Driver,_________________ is NOT allowed to drive siblings to CTA and the listed student
Driver may not drive away with the siblings after dismissal.
Mother_________________________Date:_______Father_____________________Date:__________
Only one passenger at a time is allowed to ride with the driver Please list any student that is
allowed to ride with the driver:
Passenger Signature: _______________________ Date:___________ Cell____________________
Passenger Parent Signature: Mother_____________________ Date: _______Cell______________
Passenger Parent Signature: Father ___________________ Date: _______Cell______________
12

(Continued) 2nd page Student Driver Release Form Cornerstone Tutorial Academy
Passenger Parent Home) _______________ (Work) ______________ (Cell) ______________
Driver # 1 Signature ______________________Date:________________________________
Driver # 2 Signature ______________________Date:________________________
Parents Signature for all above listed Drivers and Passengers
Mother: ________________________________Date:______________
Father: _________________________________Date:______________
In consideration of the participation of my child in the above Driving and or Passenger Activity, I waive and
release any and all rights and claims for losses and damages that I may have against Cornerstone Tutorial
Academy arising in any way from my childs Driving and/or My child/children as passengers.
In consideration of your accepting and allowing our child or children for participation in the above named
student driver release program, I hereby, for myself, my heirs, executors, and administrators, waive and
release any and all rights and claims for losses and damages that I may have against Cornerstone Tutorial
Academy and its agents, homeowners, employees, representatives, successors and assigns for any and all
losses and/or injuries suffered by myself or my child or children that rise out of the above-named Driver or
Drivers.
I warrant that I have the right to authorize the foregoing and do hereby agree to hold the above-named
organization and its agents, homeowners, employees, representatives, successors and assigns harmless of and
from any and all liability of whatever nature which may rise out of or result from such participation.
For the consideration stated above, I further agree that in the event that my child or I should make any claim
against the above named organization and its agents, Homeowners, employees, representatives, successors
and assigns for damages arising out of the above-named Drivers Release program, I will personally
indemnify, defend, and hold harmless the organization and its agents, homeowners, employees,
representatives, successors, and assigns against any and all loss and damage occasioned thereby, including
attorneys fees.
I have read and understand the Agreement and have willingly placed my signature below as evidence of my
acceptance of all the conditions contained herein.
Passenger Signature: ___________________________________Date:________
Passenger Parent Signature: Mother_________________________ Date:_______
Passenger Parent Signature Father __________________________Date_________
Driver # 1 Signature ______________________Date:______
Driver # 2 Signature ______________________Date:______
Parents Signature for all above listed Drivers and Passengers

Driver Mother: ________________________________Date:______________
Driver Father: _________________________________Date:______________
13

STATEMENT THAT YOU HAVE READ AND AGREED WITH ALL SECTIONS INCLUDED
IN THE REGISTRATION PACKET.
All Tuition and any other Fees are NON-REFUNDABLE in part or in whole.
I, _____________________________, have read this complete packet with all the Policies
included and agree to comply with everything listed in it.
Student Signature: _______________________________Date: ___________________
Mother Signature: _______________________________Date: ___________________
Father Signature: ________________________________Date: ___________________
14
Cornerstone Tutorial Academy Student Inventory

Due at Registration
(Please make 1 copy per class your child will participate in)
1. What is your favorite hobby or pastime? ____________________________________
_____________________________________________________________________________________________
___________________________________________________
2. What is the title of your favorite book? _____________________________________
3. What is your best subject in school? Why? __________________________________
_____________________________________________________________________________________________
___________________________________________________
4. What is your worst subject in school? Why? _________________________________
_____________________________________________________________________________________________
___________________________________________________
5. What is your favorite sport? ______________________________________________
6. If you could travel anywhere in the world, where would you go and why? __________
_____________________________________________________________________________________________
___________________________________________________
7. What is something unique or interesting about you? ___________________________
______________________________________________________________________________
15

Family Name ___________________________ (Family Registration Worksheet)
REGISTRATION FEES
Please note: You will not be considered officially registered until you have paid all applicable
administration fees, registration fees, and supply fees.
Registration fees are non-refundable.
All Families
(Registration Opens Feb. 28th, 2015)
Administration Fees per Student =__________
Family Registration Fees =________________
SUPPLY FEES
All fees are due with registration. Please note: Supply Fees are non-refundable.
See student registration forms for details.
REGISTRATION PAYMENT RECORD:
Registration Fee Subtotal
= $__________
Administration Fees Subtotal
= $__________
Date __________ Cash/Check# ________ Total Amount Paid =____________
Start Date _________________________ Processed ____________________
Supply Fee Subtotal
= $__________
Please complete this form and return with payment to: Cornerstone Tutorial Academy
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New Cta Contract For Families

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New Cta Contract For Families

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Cornerstone Tutorial Academy

Home School Tutorial

Handbook & Registration Packet 2015-2016 School Year

Pages 9-15 Application/Registration Packet

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Cornerstone Tutorial Academy

General Behavior Rules

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CORNERSTONE TUTORIAL ACADEMY

*Aug. 1, *Sep. 1, *Oct. 1, *Nov. 1, *Jan. 1, *Feb. 1, *Mar.

*Aug. 1, *Oct. 1, *Jan. 1, *Mar. 1

Cornerstone Tutorial Academy Application

Preferred Hospital: ____________________________ Phone Number: ________________________________

Emergency Contact Information

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Tuition can be paid in one of Five ways:

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This form is to be filled out by the parents of the student driver

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Parents Signature for all above listed Drivers and Passengers

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Cornerstone Tutorial Academy Student Inventory

CORNERSTONE TUTORIAL ACADEMY

CORNERSTONE TUTORIAL ACADEMY

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Aug. 1, Sep. 1, Oct. 1, Nov. 1, Jan. 1, Feb. 1, *Mar.

Aug. 1, Oct. 1, Jan. 1, Mar. 1

Preferred Hospital: Phone Number: ____