Welcome to Independence Academy

Please review all linked documents and complete all sections.

Child Medical Information

Child's Name(Required)

*If health information changes, please inform the director and the child’s teacher as soon as possible. Additional forms for medication, including emergency medication, are required.

Acknowledgements and Permissions

I have read the IA Photography Waiver Information below.
Please select one:(Required)

For children to participate in nature walks, visit the outdoor classroom, and participate in specials events such as trunk or treat, permission must be given to play outside the fenced area. Enrollment in all Inde Nature School programs requires permission to play outside the fence.
Please select one:(Required)

I have read the Assumption of Risk, Release, and Indemnity Information below.
Payment will be made monthly via Quickbooks invoices. Please indicate below whether you will be paying via ACH Bank Transfer or Check.(Required)


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