Application For Enrollment

Student's Name

First NameLast Name
Student's Date of Birth

MonthDayYear
Date
What is their current/recently completed grade level?
Which academic year are you applying for?
Which program (days of attendance) are you interested in enrolling in?
Please tell us about your child's parent/guardian arrangement.
I am
Mother/Guardian Name

First NameLast Name
Mother/Guardian: Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Mother/Guardian: Email
example@example.com
Father/Guardian Name

First NameLast Name
Father/Guardian: Cell Phone
Please enter a valid phone number.Format: (000) 000-0000.
Father/Guardian: Email
example@example.com
Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is your physical address:
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Previous School Information
Previous School Name
Dates Attended
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Previous School Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Type of Curriculum: (USA Standardized, Classical, etc...)
School Records (if available)

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Has your child's educational program ever been modified for any of the following reasons?
Does your child have an IEP, 504 Plan, Education Plan or Behavioral Plan? (current or not). * A copy must be on file before scheduling a student interview.
If yes, please explain:
Has your child ever been tested by a School District, Learning Specialist, Psychologist or Medical Doctor?
Please briefly explain results. (A copy of any evaluations/previous IEP or 504 is required to be provided before the student interview.)
Has your child ever been suspended or expelled from school for any reason?
If yes, explain what circumstances occurred that led to the suspension or expulsion.
504 / IEP / Behavior Plan / Diagnostic Testing Results

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Please tell us more about your child
Does your child have any medical diagnosis/condition that would effect their learning or attendance? (i.e. migraines, seizures, tics, tremors, sleep disorders, diabetes, compromised immune system, allergies - food or environmental, etc...)
Please indicate your child's medical diagnosis/condition and relevant information. (i.e. - They have juvenile diabetes and must check their blood sugar 2x during school.)
Has your child had any major surgeries or major medical events?
Please provide information and background on any major surgeries or medical events that would be important for us to know.
Please list any organized activities that your child has participated in-such as swimming lessons, library groups, soccer, etc...
What are your child's interests?
What fears or aversions does your child have? (i.e. thunder, spiders, being alone...)
Please provide other information that would be helpful to know. For example, "my child does not like to get wet".

Educational Journey Summary
For Parents
Please write a brief summary of your child's educational journey and how you feel Kinetic Bridges would benefit your child/family.
For Students

6th grade & up
Please write a brief summary of your feelings about your education so far. How do you think Kinetic Bridges Academy might be a good fit for your educational goals? (This should be your OWN words; no AI use. We want to know how we can help you reach your own educational goals.)

Statement of Faith and Beliefs
Kinetic Bridges believes and unapologetically teaches that every person is a unique creation; loved by God. Therefore, we treat all people with respect, honor, compassion kindness, dignity, and love as modeled by Jesus Christ. At Kinetic Bridges, we believe in modeling and representing Jesus to the world. Therefore, hateful, harassing behaviors or attitudes directed toward any person or group, for any reason, are not in accordance with Scripture, nor the beliefs of Kinetic Bridges.

We provide and act in accordance with a Christian Biblical model. All staff will unapologetically teach consistent with the following beliefs. At times, it may be necessary to discuss secular concepts at age-appropriate levels for students so they may learn how to defend their faith in a secular world.

We believe:
- The Holy Bible/Scripture is the inspired Word of God. It is infallible, whole, and complete. The Holy Bible is fully sufficient to guide, rule, and instruct our lives and our walk of faith.
- Jesus Christ is the Son of God, born of a virgin birth as revealed in the New Testament. He is fully God, fully man, and infallible. He alone lived a perfect life, free of sin; thereby providing forgiveness and redemption to all mankind through His bodily death and bodily resurrection. Forgiveness is a free gift, unable to be bought or earned. It is freely given to all who seek the Lord's mercy, confess and forsake their sin, and enter a saving relationship with Jesus.
- All board members, staff, administrators, and teachers shall be dedicated Christians who seek the Lord, His will for their lives and have a vibrant, saving relationship with Jesus. Further, they will behave in accordance with the belief that they are a temple of the Holy Spirit.
- We believe Creation is a literal account as recorded in Genesis. God is the creator and sustainer of life; therefore all life is sacred upon creation. God is infallible and creates each individual as male or female according to His immutable purposes.
- "Marriage" only has one meaning. As Scripture indicates, marriage is the union of one man and one woman in an exclusive union. Marriage is a holy union, therefore sexual intimacy is to only occur between a man and a woman who are married to each other. Any intimate or sexual acts committed outside of marriage (including but not limited to adultery, fornication, homosexuality, bisexuality, bestiality, incest, rape, pedophilia, and use of pornography) is contrary to the teachings of the Bible. No sexual activities should be engaged in outside of marriage between a man, woman, or beast.
These statements do not fully exhaust the extent of our beliefs. The Bible itself, as the inspired and infallible Word of God, is the sole and final source of all that we believe. For the purposes of K.B. Academy's function, practices, policies, and disciplines, the Board of Directors is considered the final interpretive authority.
Statement of Understanding and Compliance (Parent/Guardian):

I understand the above statement of faith, and I further understand Kinetic Bridges Academy will teach my child in accordance with this Statement of Faith.

I choose to allow Kinetic Bridges Academy to teach in accordance with this Statement of Faith to the fullest extent and I will support such teaching in word and deed.
Parent/Guardian Signature
Do you and your family attend church regurlary?
Church Name

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Previous School Information

Please tell us more about your child

Educational Journey Summary

For Parents

For Students

Statement of Faith and Beliefs

Application & Enrollment Process Acknowledgements

Due Today:

You may expect to be contacted in 3-5 business days to confirm your application and discuss the next steps in our application process. Please contact our office at (417) 631-8269 if you have any questions.

Previous School Information

Please tell us more about your child

Educational Journey Summary

For Parents

For Students

Statement of Faith and Beliefs

Application & Enrollment Process Acknowledgements

Due Today:*

You may expect to be contacted in 3-5 business days to confirm your application and discuss the next steps in our application process. Please contact our office at (417) 631-8269 if you have any questions.

Due Today: