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Photo Release Consent

This form is part of our enrollment process.

Photo Consent

Tell us how to reach you.

Parent Name

Phone

Help us understand what your child needs.

Child Name

Child Age

Child Grade Level

Does your child have an IEP or 504 Plan?

Choose the service you're most interested in. If you're unsure, that's fine — pick "Not sure / I need guidance" and we'll help you figure it out.

Service of Interest

How did you hear about us?

Preferred Contact Method

Phone call

Text

Best Time to Contact (optional)

Additional Notes (optional)

Consent

I agree to the Privacy Policy and consent to be contacted regarding my inquiry.

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