Registration Form

M.O.T. Academy Registration Form
M.O.T. Registration Pack
  • Personal Information
  • Authorized Pick Up & Previous School
  • Emergency Contacts
  • Release of Liability
  • Medical Information
  • Current Doctors
  • Financial Information
  • CC Authorization
  • Bank Authorization
  • Photo Waiver
  • Miscellaneous
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STUDENTS PERSONAL INFORMATION

MOTHER'S PERSONAL INFORMATION

Lives w student

Phone Numbers

FATHER'S PERSONAL INFORMATION

lives w student

Phone Numbers

GUARDIAN'S PERSONAL INFORMATION

lives w student

Phone Numbers

Parent Status
In case of divorce or separation, who has legal custody of child
Is there a restraining order or legal issue

If yes, Please submit a copy of the appropriate legal document(s) regarding this court order

CANNOT PICK UP CHILD AT SCHOOL