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This is the form to register your child for Children's Fire Academy OR Childcare. Please carefully read the information and requirements below.

CHILDREN'S FIRE ACADEMY will be held on Wednesday nights at the Kearny Highschool Library from 6:30pm-9pm. Available to children of FA student's and Alumni that are ages 8-12 years old. Your children will be trained in the same things you are learning but in a more simple way they can receive and relative to their age group. Prices for Kids Fire Academy is the same as child care. Details below.

  • The cost for One child is 5 monthly payments of $50/month for a total of $250.
  • To enroll 2 or more children the cost is 5 monthly payments of $100/month for a total of $500.

Requirements for Students in Children's Fire Academy are below.

  • Weekly Reading plan and homework
  • Must attend a minimum of 10 outreaches within the 18 week semester. Student must be accompanied by a parent at outreach

 

TK Fire Academy provides optional CHILDCARE to registered FA Students on Tuesday and Wednesday nights during Class times from 6:15pm-9:15pm. Open to children ages 2 1/2-12 years old. All children MUST be potty trained in order to attend FA childcare. FA hires and pays all childcare workers and therefore must charge monthly in order to cover costs. The cost is significantly less than hiring a personal sitter just for your own child though. We do this to give all parents the best opportunity to attend Fire Academy if they desire!

  • The cost for one child is $50 per month for 5 monthly payments which is $250 total. 
  • To enroll 2 or more children the cost is $100 per month for 5 monthly payments which is $500 total.
  • Childcare is available starting 15 minutes before class begins and shuts down 15 minutes after class ends from 6:15pm-9:15pm. Your Child MUST be picked up on time. 
  • All children MUST be pre-registered to attend childcare. We have limited space so visiting children are not allowed.
  • Students are only allowed to register their own children or children they are LEGAL guardians for. 
  • Children are NOT allowed to attend Fire Academy Classes with their parents.


First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Childcare Registration

How many Children are you registering for Childcare?

List the Names and ages of the child/children you are registering.

Does your Child/children have any special challenges or health issues that would require extra care or attention from care workers? If so, please explain.
Kids Fire Academy Registration

How many Children are you registering for the Kids Fire Academy on Wednesday nights?

What are the names and ages of each of your children?

Does your Child/children have any special challenges or health issues that FA teachers should be aware of? If so, please explain.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the parent or court-appointed legal guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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