2021-2022 Chicago Hope Academy: Student Enrollment Packet

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Welcome

Thank you for filling out the Student Enrollment Paperwork for the 2021-2022 school year at Chicago Hope Academy. If you're new to Hope this year, we're excited for you to join the Hope Family! If you're returning, we are looking forward to another awesome year!

Please note the checklist below. Each step must be completed in order to secure your student's enrollment at Chicago Hope Academy for the 2021-22 school year.

CHECKLIST:

Completion of all items in this form with a successful E-Signature submission
Upload all of the applicable documents to this form:

Birth Certificate (Freshmen & Transfer Students Only)
Parent's State ID, Driver's License, or Passport
Copy of Taxes
Utility Bill
IHSA 2021 Sports Physical – must be signed by a doctor (required for all students annually)
IDHS Full Physical Form (required for all Freshmen & Transfer Students)
Immunization Record – immunizations must be up to date (required for all Freshmen, Transfer Students and Seniors).
Dental Exam (required for all Freshmen & Transfer Students)

Signature and return of the Financial Aid Award Letter (supplied by the Admissions Office)
$400 non-refundable Enrollment Fee (payable on our website using your student's enrollment ID, which is provided by the Admissions Office)
Successful reservation and application to the Invest in Kids tax credit scholarship through Empower Illinois (instructions for applying can be found here)

Contact Information

Parent/Guardian Responsible for Enrollment Packet

Parent/Guardian completing this form

Parent/Guardian First Name

Parent/Guardian Last Name

My Student is a...

New Student (Freshman or Transfer)Returning Student (10th, 11th, or 12th grade student that attended Hope in 2020-21)

Student ID (4 or 5-digit number – can be found on PowerSchool)

Enrollment ID (the letter E followed by a 4-digit number – can be found on Financial Aid Award Letter)

Student

Student's First Name

Middle Name

Last Name

Gender

MaleFemale

Student's Race/Ethnicity

Grade for 21-22 SY

Student's Date of Birth

Student's Home Address

City

State

Postal Code

Chicago Neighborhood

Student's Cell Phone

Student's Email Address

Primary Legal Guardian

Legal Guardian's First Name

Legal Guardian's Last Name

Legal Guardian's Preferred Language

EnglishSpanishOther

Other

Legal Guardian's E-Mail Address

Legal Guardian's Phone

Primary Contact

YesNo

Party Responsible for Billing

YesNo

Does Legal Guardian live at the same address as student?

YesNo

Legal Guardian's Address

City

State

Postal Code

Chicago Neighborhood

Legal Guardian's Address

City

State

Postal Code

Chicago Neighborhood

Would you like to provide the student's father's contact information?

YesNo

Father

Father's First Name

Father's Last Name

Father's Preferred Language

EnglishSpanishOther

Other

Father's E-Mail Address

Father's Phone

Primary Contact

YesNo

Party Responsible for Billing

YesNo

Does Father live at the same address as student?

YesNo

Father's Address

City

State

Postal Code

Chicago Neighborhood

Father's Address

City

State

Postal Code

Chicago Neighborhood

Would you like to provide the student's mother's contact information?

YesNo

Mother

Mother's First Name

Mother's Last Name

Mother's Preferred Language

EnglishSpanishOther

Other

Mother's E-Mail Address

Mother's Phone

Primary Contact

YesNo

Party Responsible for Billing

YesNo

Does Mother live at the same address as student?

YesNo

Mother's Address

City

State

Postal Code

Chicago Neighborhood

Mother's Address

City

State

Postal Code

Chicago Neighborhood

Emergency Contact(s)

In case of emergency or illness, list individuals who should be contacted if we are unable to contact you at home or at work.

Emergency Contact 1

Name

Phone

Relationship to Student

Emergency Contact 2

Name

Phone

Relationship to Student

Emergency Contact 3

Name

Phone

Relationship to Student

Admission Acceptance

PLEASE INDICATE YOUR ACCEPTANCE OF ADMISSION TO CHICAGO HOPE ACADEMY BY CHECKING THE APPROPRIATE BOX BELOW.

This spot is not guaranteed until this form is signed and submitted, and the non-refundable $400 enrollment fee is paid.

Please read the following before selecting below:

We assume your permission to publish your child’s picture or video of your student in marketing material. We assume your permission to transport your son/daughter to sports activities and other school events.

We ask you to read the student handbook that is distributed when school begins in August. We ask that both the student and the parent understand and work with CHA to see that the goals and guidelines described in the student handbook are upheld.

WE AGREE TO ALL OF THE ABOVE

YES, I accept admission to Chicago Hope Academy for my student. Please secure his/her spot in classes for the 2021-2022 school year.

Athletic Interest

Does your student have interest in participating in athletics this year at Chicago Hope Academy? (Please mark "yes" even if there is a remote chance of your student participating)

YesNo

Please select any sports your student may be interested in.

Boys BasketballGirls BasketballBoys BaseballGirls CheerleadingBoys Cross CountryGirls Cross CountryBoys FootballBoys RugbyGirls RugbyBoys SoccerGirls SoccerGirls SoftballBoys Track & FieldGirls Track & FieldBoys VolleyballGirls VolleyballBoys Winter Track & FieldGirls Winter Track & Field

The following information is for athletic rosters and college recruiting.

Height

Weight

lbs

Apparel

T-Shirt Size

Short Size

Athletic Participation Agreement

CHICAGO HOPE ACADEMY
2020-21 Athletic Participant/Guardian Agreement

Agreement to Participate in Athletic Program: My child has permission to participate in the Chicago Hope Academy Athletic Program. I understand that the school is not liable for any injuries my child may receive while participating, and I assume all risks for any injuries my child may sustain as the result of participating in the athletic program. I agree to indemnify and hold the School, its employees, agents, coaches, Board of Education, and volunteers harmless from any and all liability, actions, or claims of any kind and nature that may arise while the student is participating in the school sponsored athletic program, including relating to physical injury to the student or others, or contracting COVID-19 while participating in the above indicated sport. The terms hereof shall serve as release and assumption of risk for the student and parent/guardian and for all members of the student’s and parent/guardian family. I further consent to any treatment deemed necessary by a licensed physician or athletic trainer designated by the School. If any term, covenant, condition or provision of this waiver is held by a court of competent jurisdiction to be invalid, void or unenforceable, the remainder of the provisions shall remain in full force and effect and shall in no way be affected, impaired or invalidated. I am aware that participation in sports involves travel with the team, and that the school is responsible for transporting all athletes to and from all events, and I accept the risks inherent in all travel associated with the sport in which the student is participating in. If I plan to transport my child to or from an event, I must inform the coach ahead of time.

Concussion Policy: I understand that the IHSA and Chicago Hope Academy have implemented policies and procedures regarding the treatment of concussions and head injuries, which require, among other things, that a student who exhibits signs or symptoms consistent with a concussion or head injury must be removed from participation/competition at that time and not allowed to return to play until cleared by a licensed physician or certified athletic trainer. These concussion protocols are in compliance with the current IHSA Concussion By-laws.

IHSA Performance Enhancing Drug Policy: Any student-athlete who uses a substance from the association’s banned drug classes, without written permission from a licensed physician, violates IHSA By-law 2.170, and is subject to IHSA penalties, including ineligibility from competition. We consent to random testing in accordance with the IHSA’s current steroid testing policy.

Athletic Code of Conduct: Participating in the Athletic Program is considered an extension of the regular school program. The student-athlete must agree to abide by the Chicago Hope Academy Code of Conduct as outlined in the Chicago Hope Academy Handbook, while participating in the Athletic Program. We understand that the Chicago Hope Academy Code of Conduct is in effect 365 days a year, and that any violations which negatively impact the school, team, or community, may result in dismissal from the team and the Chicago Hope Academy Athletic Program. I acknowledge that I have received and read the above Agreement to Participate and that I agree to abide and be bound by the terms of this agreement.

Joseph Salituro

Athletic Director

I am in agreement to the Athletic Participation Agreement above.

Yes

Empower Illinois Agreement & Acknowledgement

All students at Chicago Hope Academy must apply for the Empower Illinois tax credit scholarship. Please see the letter from Empower Illinois below:

Dear Families,

We are excited that you are applying for a tax credit scholarship through Empower Illinois! Please note that in order to be considered for a scholarship, families must complete both a reservation and application.

The reservation (https://reservation.empowerexchange.org/) consists of two pages. On page one, you will enter basic information, such as parent name, student name, and contact information. Please remember to use an email address that is unique to you. On page two, you will review this information and click submit. Only after clicking submit on page two will you receive your first come, first-served timestamp.

Each family only needs one reservation. Just make sure to list all children who are applying for a scholarship in the order in which you would like them to receive an award.

After completing your reservation, you will receive an email with an invitation to set up your EmpowerXChange portal and start your application.

For more information read the following documents, which can also be found on Empower Illinois' website under "How Do I Apply." Feel free to reach out to Empower Illinois' Schools Helpline (Schools@empowerillinois.org, 800-616-7606) or Traci Melcher (tmelcher@chicagohopeacademy.org) for assistance with this process.

Applying for the tax credit scholarship detailed above is a requirement of all students who wish to receive financial aid through Chicago Hope Academy.

Read the letter above and check the acknowledgment below.

I/We understand that to receive financial aid from Chicago Hope Academy, applicant must also apply for the Empower Illinois Tax Credit Scholarship. Empower Illinois portal will open mid January. Failure to apply for both may result in ineligibility for Chicago Hope Academy financial aid. Link to apply for Empower Illinois Tax Credit Scholarship : https://reservation.empowerexchange.org/

Liability Release Form 2021-2022

1. Authorization is hereby granted, by the undersigned, to Chicago Hope Academy and its representatives or agents (hereafter collectively referred to as “Chicago Hope Academy”) under any circumstances considered to be an emergency by Chicago Hope Academy to transport the above-named student to any hospital, clinic, or physician’s office and to agree to and sign for any emergency medical treatment deemed necessary. The undersigned further agrees to pay for all medical expenses associated with such emergency medical treatment and further releases from liability and agrees to hold harmless Chicago Hope Academy from any and all suits, claims, causes or action or demands of any kind or character whatsoever arising out of any damage, injury or death occasioned at Chicago Hope Academy, or activities under its supervision, and during travel to and from any such activities or emergency medical treatment as authorized under this release or at the hospital, clinic or physician’s office during treatment.

2. This authorization includes the administration of such anesthetics, transfusions, intravenous medications, oral medications, and the performance of such diagnostic studies including x-ray examinations and operative (surgical) procedures as advised by a duly licensed surgeon or physician chosen by Chicago Hope Academy if it is impossible to contact physicians listed in this document or if they are unavailable for consultation.

3. I hereby give consent for the above-named student to participate in Chicago Hope Academy approved sports or activities (including without limitation, collision sports), and travel with the coach or other representative of Chicago Hope Academy on any trips.

4. I have set out below any special concerns that I have regarding athletic participation or any activities in which I would like to limit the above-named student

5. The undersigned further acknowledges familiarity with the dangers involved to the above-named student in competing in athletic, intramural, or other events requiring physical activity. It is understood that even though protective equipment may be worn by the athlete, the possibility of accidents and injuries still remains. The undersigned hereby releases and holds Chicago Hope Academy harmless and assumes full and complete responsibility for any injury which may occur to the student as a participant or spectator in any such event or activity.

6. I have set out below certain medical conditions of the above-named student that are known to me which may be of importance should the above named students require medical attention. (Set out below any known medical conditions such as heart murmurs, allergic reactions to any medications, epilepsy, adverse reactions to certain anesthetics, heart disease, high blood pressure, diabetes, asthma, bleeding or clotting disorders, orthopedic, spinal, or head injuries, heart-related problems, etc.)

7. We assume permission to publish your child’s picture in our publications such as newsletters, website, and school events.

8. If such an emergency arises where treatment at a hospital, clinic, or physician’s office is necessary, please contact those listed on the following page.

9. Acceptance of this form allows Chicago Hope Academy to appoint professional medical services to treat minors under the age of 18. This form must be Consented to if the student is under the age of 18 at the start of the season. Chicago Hope Academy cannot appoint medical care without parental consent. I grant permission for my child to be seen by physicians, doctors, and or trainers appointed by Chicago Hope Academy.

AGREEMENT TO THE TERMS STATED ABOVE

YES, I accept the terms stated in the "Liability Release Form 2021-22" (found above)

Does your student have asthma?

YesNo

Liability Release Form (Medical Information)

Physician

Physician Name

Physician Phone

Physician Address

Physician Address Line 2

State

City

Postal Code

Preferred Hospital or Clinic

Hospital/Clinic Name

Hospital/Clinic Phone

Primary Insurance Coverage

Insurance Company Name

Insurance Company Phone

Name of Insured

Insurance Policy Number

Chicago Hope Academy Chromebook/Laptop Use Policy Summary

Chicago Hope Academy issues computer devices to its students. Students receiving a device, along with their parents, must agree to the following responsibilities:

Student Responsibilities

Your Chromebook/laptop is an important learning tool and is for educational purposes only. In order to take your laptop home each day, you must be willing to accept the following responsibilities:

• I know this computer is on loan to me. All policies, procedures, applicable laws and the Network and Internet Policy must be followed. I understand that any violation could result in loss of the computer for my use.

• I will treat the Chromebook/laptop with care and will be responsible in using the laptop.

• I will not loan the Chromebook/laptop to others; it will stay in my possession at all times.

• I will not load or delete any software from the Chromebook/laptop, and I will comply with all copyright laws.

• I will not give personal information when using the Internet.

• I will not attempt to make any repairs to the Chromebook/laptop.

• I understand that misuse or inappropriate use as determined by school personnel may result in any and/or all of the following:

o Student conference or Parent conference

o Cancellation of access privileges and/or loss of computer privileges

o School disciplinary actions including civil or criminal liability under applicable laws

Parent Responsibilities

Your child has been issued a Chromebook/laptop computer to improve and personalize his/her education this year. It is essential that the following guidelines be followed to ensure the safe, efficient, and ethical operation of your child's computer.

• I will discuss school policies and expectations regarding the use of the Internet and will supervise my child's use of the Chromebook/laptop at home.

• I will not attempt to make any repairs to the Chromebook/laptop.

• I will report to the school any problems with the Chromebook/laptop.

• I will not load or delete any software from the Chromebook/laptop and I will comply with all copyright laws.

By checking below, you are agreeing to bear the responsibilities stated in the "Chromebook/Laptop Use Policy Summary" above.

Yes, I agree

Chicago Hope Academy Computer Loan Agreement

A Chromebook/laptop is being loaned to the Borrower for academic purposes. It is the borrower's responsibility to care for the equipment and ensure it is maintained in a safe environment. A $250.00 fee will be assessed to cover the cost of replacement if the computer is lost, stolen or damaged. Parents/guardians/students should immediately notify the main office if any of the above issues occur.

The Chromebook/laptop computer, computer charger brick, charger cord and mouse are the property of Chicago Hope Academy and is herewith being loaned to the student for educational purposes only for the academic school year. Students may not deface or destroy this property in any way. Inappropriate material on the machine will result in the student losing their right to use this computer, The equipment will be returned to the school on a date to be requested or sooner if the student is discharged from school prior to the end of the school year. Students who do not return the computer and related materials when requested may be subject to criminal prosecution or civil liability. A late fee may be charged if the laptop is not returned to the school district on the required check-in date.

Borrower may not install or utilize any software in connection with Borrower's use of the laptop equipment other than software owned by the Chicago Hope Academy and made available to Borrower in accordance with this receipt and agreement and Borrower agrees not to make any unauthorized use of or modifications of such software.

Chicago Hope Academy is not responsible for any computer or electronic viruses that may be transferred to or from Borrower's device or other data storage medium and Borrower agrees to use Borrower's best efforts to assure the property is not damaged or rendered inoperable by any such electronic virus while in Borrower's possession.

By marking here, Borrower and Borrower's parent/guardian acknowledge and agree to the terms of use as spelled out in the Chromebook/Laptop Use Policy Summary and this Computer Loan Agreement Form. Additionally, they agree that Borrower's use of the District Property is a privilege, and that by Borrower's agreement to the terms hereof, Borrower acknowledges Borrower's responsibility to protect and safeguard the District Property and to return the same in good condition and repair.

YES, I agree to the terms stated above.

IHSA Concussion Information Sheet & Performance-Enhancing Substance Policy

In 2008, the IHSA Board of Directors established the association's Performance-Enhancing Substance (PES) Policy. A full copy of the policy and other related resources can be accessed on the IHSA Sports Medicine website. Additionally, links to the PES Policy and the association's Banned Drug classes are listed below. School administrators are able to access the necessary resources used for policy implementation in the IHSA Schools Center.

As a prerequisite to participation in IHSA athletic activities, we have reviewed the policy agree that I/our student will not use performance-enhancing substances as defined by the policy. We understand that failure to follow the policy could result in penalties being assigned to me/our student either by the my/our student's school or the IHSA.

IHSA PES Policy

http://www.ihsa.org/documents/sportsMedicine/2017-18/2017-18 PES policy.pd! IHSA Banned Drug Classes

http://www.ihsa.org/documents/sportsMedicine/current/lHSA Banned Drugs.pd!

Consent to Self Administer Asthma Medication

Illinois Public Act 098-0795 provides new directions for schools concerning the self-carry and self-administration of asthma medication by students. In order for students to carry and self-administer asthma medication, parents or guardians must provide schools with the following:

Written authorization from a student's parents or guardians to allow the student to self-carry and self administer the medication.
The prescription label, which must contain the name of the asthma medication, the prescribed dosage, and the time at which or circumstances under which the asthma medication is to be administered.
A full copy of the law can be found at http://www.ilga.gov/leqislation/publicacts/98/PDF/098-0795.pdf.

Student/Parent Consent and Acknowledgements

By marking here, we acknowledge we have been provided information regarding concussions and the IHSA Performance-Enhancing Substance Policy.

Student

Student First Name

Student Last Name

Parent or Legal Guardian

Parent First Name

Parent Last Name

Photo Release Form 2021-2022

This parental consent form is to both inform you and to request permission for your child's photo/image and personal identifiable information to be published on the district and/or school's website.

As you are aware, there are potential dangers associated with the posting of personally identifiable information on a website. These dangers have always existed; however, we as schools do want to celebrate your child and their work. The law requires that we ask for your permission to obtain any information about your child.

Pursuant to law, we will not release any personal identifiable information without prior written consent from you as parent or guardian. Personal identifiable information includes student names, photo or image, residential addresses, e-mail address, phone numbers and locations and times of class trips.

If you, as the parent or guardian, wish to rescind this agreement, you may do so at any time in writing by sending a letter to the principal of your child's school and such rescission will take effect upon receipt by the school.

I/We GRANT permission for this student's photo/image and all other personal identifiers listed above to be published on the school and/or district's public internet site.

AGREEMENT TO THE TERMS STATED ABOVE

YES, I accept the terms stated in the "Photo Release Form 2021-22" (found above)

Dress Code 2021-2022

For more information, please refer to the 2021-2022 Student & Family Handbook

Student uniforms can be purchased through Lands’ End School Outfitters.

To purchase uniforms:
Go to www.chicagohopeacademy.org and click on the parent tab at the top. On the right of that page will be a button saying “Parents”, click the button. Click the “Purchase Uniform” button which will lead you to the Lands’ End website, follow that to fill out a profile for your student. On the Lands’ End website you will be able to purchase all the necessary pieces of the student uniform, though only the button down shirt and sweater must be embroidered.

School Code: 900166166

Pro tip: Sign up for the Lands’ End email promotions and in a few days you will likely get up to 50% off your order! Who doesn’t love 50% off?

Official student uniform

CHA dress shirt: collared, solid white shirt with school logo, buttoned all the way up.
Business casual pants, solid navy or black (athletic pants, sweat pants, yoga pants, tight-fitting pants, denim, and leggings are unacceptable).
Optional CHA sweater or fleece: solid navy, with school logo.
Business casual, casual, or athletic shoes in solid black; flat, and closed-toe (high heels, sandals, flip-flops and boots are unacceptable).
Ties for boys: solid navy, tied squarely and securely at the collar.

Skirts for girls (alternative): solid navy, knee length.

General Guidelines

All clothing must be professional, scholarly, clean, and modest:
- No stains, wrinkles, holes, patches, ragged/ frayed edges, designs, logos, or slogans.
- No visible undergarments: undershirts, if worn, must be solid white tees􏰰
Shirts must be tucked into pants in the front and in the back.
Belts must be solid black and fastened securely.
Sweatshirts, hoodies, jackets, or coats are unacceptable.
Hats, hoods, sunglasses, and winter garments indoors are unacceptable. 􏰰
Tattoos, facial/body piercings (other than earrings for females, as outlined below) are unacceptable; existing tattoos must be covered throughout the school day and at all school-related activities and events, and existing facial/body piercings must be removed throughout the school day and at all school related activities and events.

Athletic attire, which includes athletic socks, athletic shorts, athletic pants, sweat pants, t-shirts, and sweatshirts are not acceptable outside of P.E. class, athletic events, practices, competitions, or Spirit Days.

AGREEMENT TO THE TERMS STATED ABOVE

YES, I accept the terms stated in the "Dress Code 2021-22" (found above)

College Prep Information

Standardized Testing Fee Waiver Eligibility: Students and families meeting certain criteria are eligible to have ACT, SAT, PSAT, and College Application fees waived. Please mark any/all of the following statements that apply to you or select "None of the Above".

Enrolled in or qualifies for a federal free or reduced-price lunch program at school, based on US Department of Agriculture (USDA) income levelsEnrolled in a program for the economically disadvantaged (for example, a federally funded program such as GEAR UP or Upward Bound).Resides in a foster home, is a ward of the state, or is homeless.Family receives public assistance or lives in federally subsidized public housing.Family’s total annual income is at or below USDA levels for free or reduced-price lunches on the USDA Food and Nutrition Service website.Student is a ward of the state or an orphan.None of the above.

First-Generation Status: A First-Generation Student is defined as a student without a parent with a bachelors (four-year) degree. Would your student be considered a First-Generation Student?

Yes, neither one of the student's parents possess a bachelors degree.No, one (or both) of the student's parents possess a bachelors degree.

Title I Letter

Title I Consent

I have read the letter on the previous page and agree/do not agree that my child may participate in the Title I program outlined on the previous page.

AgreeDo not agree

In the event of a mandatory school closure, Title I Instructional E-Learning program may continue as a supplemental program. I understand and would like my child to participate.

AgreeDo not agree

Student First Name

Student Last Name

Address

City

State

Postal Code

Parent/Guardian First Name

Parent/Guardian Last Name

Lake Geneva Youth Camp Waiver

LGF Release, Indemnification and Hold Harmless Agreement

In consideration of participating in activities, and for other good and valuable consideration, I hereby agree to release and discharge from liability arising from negligence Lake Geneva Foundation, Lake Geneva Youth Camp and Conference Point Center and its owners, directors, officers, employees, agents, volunteers, participants, and all other persons or entities, acting for them (hereinafter collectively referred to a “Releasees”'). on behalf of myself and my children, parents, heirs, assigns, personal representative and estate. and also agree as follows:

I acknowledge that participating in any physical activity including, but not limited to, walking, running, hiking, basketball, volleyball, sand volleyball, soccer, dodgeball, human foosball, gaga ball, 9 square in the air, shuffleboard, tether ball, playground equipment, floor hockey, broom ball, disc golf, horseshoes, fishing, tennis, softball, bocce ball, campfires, field games, any activity in the gym, game room, or any activity my group orchestrates while on property or any of the staffed elements including, but not limited to, archery, boat rides, banana boating, tubing (water and snow), waterskiing, wakeboarding, swimming, canoeing, paddle boating, kayaking, climbing wall, giant swing, mountain biking, paintball, teams course/challenge course, toboggan run, waterslide, zip line, zorb ball, and laser tag, involves known and unanticipated risks which could result in physical or emotional injury, paralysis or permanent disability, death and property damage. Risks include but are not limited to broken bones, torn ligaments or other injuries as a result of falls or contact with other participants, insect bites (spiders, ticks, bed bugs, mosquitoes, etc.): death as a result of drowning or brain damage caused by near drowning in lakes or other bodies of water: medical conditions resulting from physical activity; and damaged clothing or other property. I understand such risb simply cannot be eliminated despite the use of safety equipment, without jeopardizing the essential qualities of the activity.

I expressly accept and assume all of the risks inherent in this activity or that might have been caused by the negligence of the Releasees. My participation in this activity is purely voluntary and I elect to participate despite. the risks. In addition, if at any time I believe that event conditions are unsafe or that I am unable to participate due to physical or medical conditions, then I will immediately discontinue participation.

I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Releasees from any and all claims, demands, or causes of action which arc in any way connected with my participation in this activity, or my use of their equipment or facilities, arising from negligence. This release does not apply to claims arising from intentional conduct. Should Releasees or anyone acting on their behalf be required to incur attorney's fees and costs to enforce this agreement. I agree to indemnify and hold them harmless for all such fees and costs.

I represent that I have adequate insurance to cover any injury or damage I may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or damage myself. I further represent that I have no medical or physical condition which could interfere with my safety in this activity, or else I am willing to assume - and bear the costs of - all risks that may be created, directly or indirectly, by any such condition.

In the event that I file a lawsuit. I agree to do so in the state where Releasees’ facility is located and I further agree that the substantive law of that state shall apply.

I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall remain in full force and effect.

By signing this document, I agree that if I am hurt or my property is damaged during my participation in this activity, then I may be found by a court of law to have waived my right to maintain a lawsuit against the parties being released on the basis of any claim for negligence.

I have had sufficient time to read this entire document and, should I choose to do so, consult with legal counsel prior to signing. Also, I understand that this activity might not be made available to me or that the cost to engage in this activity would be significantly greater if I were to choose not to sign this release, and agree that the opportunity to participate at the stated cost in return for the execution of this release is a reasonable bargain. I have read and understood this document and I agree to be bound by its terms.

Student First Name

Student Last Name

Student Address

City

State

Postal Code

Parent First Name

Parent Last Name

In consideration of my student being permitted to participate in this activity, I further agree to indemnify and hold harmless Releases from any claims alleging negligence which are brought by or on behalf of minor or are in any way connected with participation by minor.

I agree to the above

Enrollment Checklist | Document Uploads

The documents requested below are required for enrollment at Chicago Hope Academy. Please upload a pdf or a photo of each of the requested documents.

Chicago Hope Academy 2021-22 Financial Aid Award Letter – Must be Signed

Student's Birth Certificate (New & Transfer Students only)

Parent's ID (State ID, Driver's License, or Passport)

Copy of Taxes

Utility Bill

IHSA Sports Physical (must be signed by doctor. Required annually for every student.)

IHSA Sports Physical Exam Date

IDHS Full Physical -- Freshman and Transfers only. This must turn in and be in compliance. If not in compliance, you must receive the necessary immunizations before the start of school to avoid exclusion.

IDHS Full Physical Exam Date

Immunization Record – Freshman & Transfer Students only. Immunizations must be up to date.

Immunization Record – Rising Seniors: Updated Immunizations Required.

Dental Exam -- Freshman & Transfer Students only.

Dental Exam Date -- Freshman & Transfer Students only.

Asthma Action Plan

E-Signature Reminder

Note: In order for your submission to be marked as complete, you must finalize the E-Signature portion of this document.

This is done by signing at the bottom of the next page (after you press "Submit") and clicking the link in the follow-up email you will receive upon hitting submit.

If you fail to complete the E-Signature portion of this form, your submission will be deemed invalid and your student's enrollment to Chicago Hope Academy incomplete.

E-Signature Acknowledgement

I acknowledge that I have read the note above and will complete the E-Signature portion of this form on the next page and through the follow-up email I will receive.

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Contact Information