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NEW STUDENT APPLICATION
Student Full Name
Guardian #1 Full Name and Relationship to Student (Youth Students)
Guardian #2 Full Name and Relationship to Student (Youth Students)
Student Gender
Age
Date of Birth
Contact Email
Contact Email 2 (Optional)
Contact Phone
Contact Phone 2 (Optional)
Address
What brings you to Stillness Academy?
Any previous experience with sports, leadership, fitness, or martial arts?
Please describe any chronic pains, allergies, previous surgeries, and current medical or mental health issues, so we may better serve you.
Please list any current drugs / medications used:
Describe yourself (or your child):
What are your / your child's Strengths? Struggles?
How did you hear about Stillness Academy?
Youth Students Only: Image of Recent Report Card
Upload File
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Signature: I have read, understand, and agree to the policies outlined in the Enrollment Policy Guide
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Thanks for applying!
We’ll get back to you soon.
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