EFA Student Registration | Fundamentals Go

K - 8th Grade

Study Buddies

Student Registration

Once you submit the student registration form below, you will receive an emailed invoice to complete EFA Direct Pay processing. A separate registration form is required for each student. If you are registering siblings, you do not need to repeat the emergency contact section for each child. An itemized invoice will be sent within 48 hours.

Student's First Name

Student's Last Name

Student's Grade

Age

Gender

Student's Birthday

Month

Day

Year

Mailing Address

Country/Region

Address

City

Zip / Postal code

Parent/Guardian Information

Parent/Legal Guardian First Name

Parent/Legal Guardian Last Name

Parent/Legal Guardian Email

Parent/Legal Guardian Phone

Secondary Parent First Name

Secondary Parent Last Name

Secondary Parent Email

Secondary Parent Phone

Emergency Contact Information

#1. Emergency Contact (First and Last Name)

Relationship to Student

#1. Emergency Contact (Phone)

#2. Emergency Contact (First and Last Name)

Relationship to Student

#2. Emergency Contact (Phone)

#3. Emergency Contact (First and Last Name)

Relationship to Student

#3. Emergency Contact (Phone)

#4. Emergency Contact (First and Last Name)

Relationship to Student

#4. Emergency Contact (Phone)

#5. Emergency Contact (First and Last Name)

Relationship to Student

#5. Emergency Contact (Phone)

(If Applicable) My student MAY NOT BE RELEASED to the following individuals:

If you listed a parent of your student in the above field, a restraining order must be on file.

Member Health Information

Physician

Clinic Phone

Clinic Location

Medications

Do your student or students have any special needs, allergies, or medical conditions we should be aware of?

Yes

If yes, please explain:

Member T-Shirt Information

A Study Buddies Program subscription includes access to FUNdamentals Go Social Clubs. After you complete this form, you’ll receive an email with instructions for your student to select their Social Club. EFA funding covers the cost of Social Club uniform shirts. ($35 per shirt)

I would like to order a club shirt.

Yes

If yes, how many?

Student T-Shirt Size

Uniform Payment Options:

EFA Direct Pay

EFA Reimbursement

Private Pay

By checking this box, I acknowledge that I have read and signed a copy of the FUNdamentals Go Student Handbook.

By checking this box, I acknowledge that I have completed and submitted a FUNdamentals Go Student Waiver.

Parent/Guardian Information

Emergency Contact Information

Member Health Information

Member T-Shirt Information

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