REGISTRATION !
Student name ____________________________________________ Gender M F Birth date _______________ Grade ______ Address __________________________________________________________________________ School __________________________ City _________________________________________ Zip _______________ Phone no . ( Home ) ________________________________ Accommodation needs _____________________________________________________________________________________________ Parent / Guardian name _________________________________________ ( Work ) _____________________ ( Cell ) __________________
Parent / Guardian email address ______________________________________________________________________________________
Providing us with an email address allows us to contact you in case of schedule changes .
Cash , Check no . ___________ or Visa MasterCard Discover American Exp . ( Check one ) Amount $____________________ Cardholder signature required _____________________________ Exp . date _________/_________ Checks payable to Anoka-Hennepin District No . 11 Credit card no . ________ ________ ________ ________ — ________ ________ ________ ________ — ________ ________ ________ ________ — _______ ________ ________ ________ Course name _________________________________ Location ___________________ Number _________________ Fee __________ Course name _________________________________ Location ___________________ Number _________________ Fee __________ Course name _________________________________ Location ___________________ Number _________________ Fee __________ Athletic participants must have a Sports Qualifying Physical , and Eligibility and Emergency Health form on file at your schools ’ Community Education office . Do you have these forms on file ? Yes No ( Check one ) Please list significant health , injury , or concussion concerns :_______________________________________________________________ Registration Information and Frequently Asked Questions
Online registration Register at www . discovercommunityed . com . Convenient , secure , 24-hour registration using your Visa , MasterCard or Discover Card . Click on “ register ”, enter the class name into the search box or scroll to the bottom of page for two options , classes-by school or classesdistrictwide .
Drop-off registration Drop-off a separate form and payment for each class location at your school ’ s Community Education office M-F from 8:30 a . m . - 4:30 p . m .
Fee assistance Students who qualify for free or reduced-priced meals pay the fee listed to the right of the class fee . Example : ($ XX )
Inclement weather Decision to cancel will be made just prior to class time . All outdoor activities that are canceled will not be rescheduled or refunded .
Anoka-Hennepin Community Education 763-506-1286
Transportation Activity buses are available M-Th for all middle school programs that meet immediately after-school .
Payment You may pay with a personal check , cash or credit card . Make checks payable to Anoka- Hennepin Schools . Registrations are not complete without payment . A registration confirmation will be emailed to you if an email address is provided . Classes are filled on a first-come , first-serve basis . Activities with low enrollment will be canceled . Participants will be notified and payment refunded .
Refund policy Customer-initiated cancellations made at least five business days before the class is scheduled to start may qualify for a partial refund . Customer-initiated cancellations made less than five business days are not eligible for a refund .
Photos and video : Anoka-Hennepin Schools staff , volunteers , representatives of the news media and others occasionally photograph and videotape participants in our programs . The photos and video may be used for district and departmental promotions , or in school and department-related publications , videos , web and social media sites as appropriate . Anoka-Hennepin Community Education will take reasonable steps to prevent participants who prefer not be photographed / videotaped , but cannot guarantee that participants will not be photographed / videotaped as part of a large group or public event , such as a theatre production or athletic event .
22