Registration | Mind Spring Academy

To register, please fill out the form below.

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First name

Last name

Grade

Birthday

Year

Month

Day

Areas needing support

Math

Reading

ESL / ELL

Parents / Guardians Full Name

E-mail Address

Home Address

Phone Number

Emergency Contact Name

Emergency Contact Phone Number

Relationship to students

Does the student have any learning, behavioural, or developmental needs we should be aware of?

Does your child have any medical conditions?

Does your child have any allergies? (food, medication, environmental)

Will your child be picked up or walk home independently?

Pick-up by parent/guardian

Walk home with permission

Pick-up by authorized person

Authorized pick-up persons Name

Phone number

Anything the parent wants the instructor to know?

I understand and agree that this program requires a minimum 3-month commitment to support meaningful academic progress and consistency in learning.

I understand that students are expected to maintain respectful, safe, and cooperative behaviour. I understand that disruptive behaviour will be communicated to parents and may result in suspension or removal from the program.

I understand the attendance expectations and acknowledge that regular attendance is important for student learning, progress, and continuity of instruction.

I understand that tuition fees are based on enrollment and are not adjusted for missed classes due to illness, absence, or personal reasons.

I understand that the program provides academic support to the best of its ability but does not guarantee specific grades at school.

I give permission for program staff to take appropriate action in the event of an emergency, including contacting emergency services (911) and seeking medical assistance if necessary.

I give permission for my child’s photo to be used for the following purposes:

Registration records and classroom/class photos

Internal program use (progress tracking and documentation)

Website or promotional materials.

I acknowledge and agree to the following program terms:

A minimum 3-month commitment is required

I understand and agree to the refund policy (no refunds during the 3-month commitment period; withdrawal requests must be submitted at least 20 days before the next 3-month cycle).
Payments will be made monthly through the website, and my card information will not be stored by the program.
I agree to a monthly tuition fee of $290, which will be automatically charged each month until cancelled.

Registration Fee

$25

What Happens Next?

Our team will review your information and reach out within 24 hours to confirm the schedule.