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* 1. Student Last Name

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* 2. Student First Name

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* 3. Parent Last Name

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* 4. Parent First Name

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* 5. Student Email

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* 6. Parent Email

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* 7. Home Address, City, State, Zip Code

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* 8. Student Phone number

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* 9. Parent phone number

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* 10. Student birthdate

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* 11. What grade are you in?

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* 12. Emergency contact and phone

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* 13. How many years has this student been homeschooled?

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* 14. Have you or a sibling ever been part of BUAC Electives before?

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* 15. Have you or a sibling ever been part of another BU program?

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* 16. Have you ever been dismissed from a public school, private school,  or home school co-op or program?

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* 17. If yes to question 16, please explain. Answer N/A if no.

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* 18. Medical Insurance Company

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* 19. Insurance company ID#

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* 20. Insurance company group #

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* 21. Insurance company plan #

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* 22. Insurance member name

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* 23. Insurance member employer

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* 24. Student's doctor and phone number

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* 25. List any medical conditions of the student

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* 26. List any drug or food allergies

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* 27. BUAC Electives and Bluegrass United Contracts of Understanding

BUAC Electives students and parents are required to read, sign, and abide by the following contracts. Please read each contract and digitally sign the signature boxes. 

BUAC Electives is designed for the mature, independent high school student who works cooperatively in group settings. It employs a university model of instruction and administration that holds students directly and solely accountable for their behavior and academic performance and swiftly addresses students who are not ready or committed to this academic model. This model and its specific requirements and expectations are explained in detail on the BUAC Electives web site at www.buacelectives.com. Students are charged with full responsibility for reading and implementing the student requirements outlined in this section of the web site.

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* 28. Bluegrass United offers leadership driven, private programs for high school homeschool students. Participating families enter into a voluntary association with Bluegrass United when they register for Bluegrass United programs. This relationship remains until such time that either party decides the relationship is no longer beneficial to the student or Bluegrass United.

By checking the boxes below, both students and parents are stating they

1) Have read and will abide by the rules, expectations, and guidelines of Bluegrass United (as outlined at www.bluegrassunited.com and www.buacelectives.com) and the programs in which they participate.

2) Are willing to place themselves under the authority of Bluegrass United while they are participating in Bluegrass United programs.

3) Will hold harmless and remove from any and all liability the leadership of Bluegrass United and all its program leaders, instructors, facilities, coaches, volunteers, and all others involved in any way with Bluegrass United programs or events.

This will serve as a digital signature.

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* 29. The online class selection process must be fully and accurately completed.
By checking the boxes below, both students and parents are stating they:

1) Understand students can sign up for one, two, or three classes at BUAC
Electives but cannot be on campus during hours in which they do not select a class.

2) Understand students are required to select three class choices each hour (or “no class this hour”) for each hour they attend, in order for class selections to be properly processed. (This enables students to be correctly assigned and reassigned should changes need to be made in the master schedule.)

3) Understand students cannot attend Fellowship Hour from 12-1 pm if they are not enrolled in a 1 p.m. class.

4) Please see buacelectives.com to view descriptions of classes and teacher biographies.

This will serve as a digital signature.

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* 30. Choose a first choice class for 1 pm:

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* 31. Choose a second choice class for 1 pm:

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* 32. Choose a third choice class for 1 pm:

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* 33. Choose a first choice class for 2 pm

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* 34. Choose a second choice class for 2 pm

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* 35. Choose a third choice class for 2 pm

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* 36. Choose a first choice class for 3pm

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* 37. Choose a second  choice class for 3 pm

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* 38. Choose a third  choice class for 3 pm

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* 39. For parents:  BUAC Electives is coordinated and run by moms and dads like you.  We are always needing volunteers to help things run smoothly.  Please check any boxes in which you are available to be called upon to volunteer.  Checking boxes does not mean you are volunteering instantly.  ;-)  We will put you on a list to call upon when we have a need.  Thank you!  We appreciate all you do to invest in your students!  Please select all that apply:

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