NEW STUDENT ENROLLMENT

Student Registration

This form is for registering a new student with Xstar Education. Complete the student information first; agreement review and electronic signature become available after the required information is complete.

1Information

2Review & Sign

3Confirmation

Student Information

Student Legal Name (First & Last) *

Date of Birth *

Gender *

Grade (2026–2027) *

Current School *

Program Selected *

Parent & Emergency Information

Parent/Guardian Legal Name *

Relationship to Student *

Parent Phone *

Parent Email *

Emergency Contact Name *

Emergency Contact Phone *

Allergies (if any) *

Medical Information (if any) *

How did you hear about Xstar Education?

Registration Summary

STUDENT

PARENT/GUARDIAN

PROGRAM

REGISTRATION ID

Enrollment Packet — Version 2026.07.1

View Enrollment Packet Documents

Select a document title to review it in the secure viewer.

Required Acknowledgments

0 of 8 required boxes selected

Authority to Sign and Accuracy of Information

I confirm that I am legally authorized to complete this registration and sign for the Student, and that the information submitted is true, accurate, complete, and current.

Receipt, Review Opportunity, and Agreement to the Complete Enrollment Packet

I confirm that I have been provided access to all four Version 2026.07.1 documents above, have had a reasonable opportunity to review them and obtain assistance, and voluntarily agree to the complete Packet.

Initials — Complete Packet *

Risk, Release, Medical Authorization, and Indemnification

I understand and agree to the assumption of risk, release of ordinary negligence claims, medical authorization, indemnification, limitation-of-liability, and related provisions described in the Packet.

Initials — Risk and Waiver *

Transportation Acknowledgment

I specifically acknowledge the Transportation Acknowledgment. Signing does not mean transportation is currently requested, but it will apply if transportation is later requested, approved, arranged, confirmed, or used.

Privacy, Data Use, and Required Promotional Media Authorization

I acknowledge and agree to the Privacy & Media Notice and specifically authorize the data uses and promotional media uses described in the Packet.

Binding Individual Arbitration, Jury Trial Waiver, and Class Action Waiver

I understand and agree that covered disputes will be resolved by binding individual arbitration, and that I am giving up jury-trial and class/collective/representative proceeding rights to the fullest extent permitted by law.

Initials — Arbitration and Rights Waivers *

Electronic Transaction, Signature, Language, and Understanding

I consent to complete this transaction electronically and understand that my name, signature, initials, checkbox selections, timestamps, IP/device records, and system logs may evidence my agreement. I have had an opportunity to obtain translation, interpretation, or legal assistance.

Final Electronic Signature

Parent/Guardian Full Legal Name *

Electronic Signature *

Use your mouse, trackpad, or finger to sign inside the box.

Final Intent to Sign

By selecting this box and clicking “SIGN AND SUBMIT,” I intend to electronically sign and be legally bound by the complete Xstar Enrollment, Waiver, Transportation, Privacy, and Consent Packet, Version 2026.07.1.

FOR CURRENTLY ENROLLED STUDENTS ONLY

Need to add or change an authorized pickup person?

If your child is already registered with Xstar Education, use the separate Pickup Authorization form. This is not a new-student registration form.

Manage Pickup Authorization →