Parent Forms Package

Enrollment Forms Package

Complete this packet after approval. These forms help Lewis Life Skills Academy support safety, communication, medical needs, behavior support, permissions, and parent acknowledgments.

1. Enrollment Application

Parent/Guardian Name *

Relationship to Student *

Email *

Phone *

Home Address *

Student Name *

Date of Birth *

Age *

Program Selected *

2. Medical Information

Diagnosis / Support Needs

Allergies

Medications

Seizure History / Medical Conditions

Dietary Restrictions

Physician Name

Physician Phone

3. Emergency Contact & Pick-Up Authorization

Emergency Contact #1 *

Emergency Contact #1 Phone *

Emergency Contact #2

Emergency Contact #2 Phone

Authorized Pick-Up Persons

4. Communication Profile

How does your student communicate best?

Preferred Communication Supports

How does your student show they need help?

5. Behavior Support Profile

Known Triggers

Calming Strategies That Work

Sensory Needs

Elopement / Running Away History

Aggression or Self-Injury History

6. Personal Care Needs

Toileting / Hygiene / Feeding Assistance Needed

Mobility Needs or Physical Limitations

Adaptive Equipment Used

7. Community Outing Consent

I give permission for my student to participate in supervised community-based activities including malls, grocery stores, movie theaters, parks, restaurants, transit learning activities, and other approved public spaces.

I understand public environments may include crowds, noise, walking, waiting, transitions, and everyday community risks.

8. Water Activity Consent

I give permission for my student to participate in supervised splash pad, pool, or water-based recreation activities.

Swimming Ability / Water Safety Notes

9. Photo & Media Release

Photo/Video Permission

10. Transportation Acknowledgment

I understand Lewis Life Skills Academy does not provide transportation. I am responsible for drop-off and pick-up at designated locations.

11. Liability Waiver & Assumption of Risk

I understand participation in community-based activities involves possible risks, including but not limited to walking, public spaces, weather, crowds, slips, falls, emotional distress, behavioral incidents, or accidental injury.

I voluntarily assume the ordinary risks associated with my student participating in Lewis Life Skills Academy activities.

I understand this waiver should not replace advice from a qualified attorney and final legal language should be reviewed professionally.

12. Parent Handbook Acknowledgment

I acknowledge that I have received or will review Lewis Life Skills Academy policies, including attendance, behavior expectations, safety procedures, illness policy, refund policy, and parent responsibilities.

13. Final Signature

Parent/Guardian Electronic Signature *

Date *

Program Pricing

Flexible Support For Every Family

Lewis Life Skills Academy offers structured community-based learning experiences designed to support confidence, independence, communication, social growth, and real-world life skills development.

Choose The Best Program Option

Our pricing is designed to remain family-friendly while still providing safe, supportive, structured, and meaningful learning experiences for every student.

Starter Program

$45

Per Session

1 structured community session
Small group participation
Life skills practice
Social interaction support
Public community setting
Parent communication updates
Confidence-building activities

Get Started

Growth Plan

$160

Full Week Program

5 sessions
Community-based instruction
Behavior support strategies
Social skills development
Confidence-building support
Routine & independence practice
Structured learning experiences

Schedule Meet & Greet

Transition Readiness

$225

Advanced Support

Older teens & young adults
Independence-building support
Real-world community practice
Daily living skill development
Goal-focused sessions
Communication confidence building
Transition readiness support

Learn More

Important Program Information

All families must complete a meet & greet before enrollment approval.
Transportation is not provided at this time.
Session locations may vary depending on activities and scheduling.
Small group environments are prioritized for safety and support.
Pricing may vary depending on support needs and outing activities.
Additional specialty outings may include separate activity fees.

Ready To Get Started?

Begin with a meet & greet so we can learn more about your student, discuss goals, answer questions, and recommend the best program option.

Schedule A Meet & Greet

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