Smart Guy Middle School Club

Confidence • Responsibility • Smart Choices

Middle School Boys

4:30 PM – 6:00 PM

Small group

$440 — 8 sessions

The Smart Guy Middle School Club is designed to help boys transition into middle school with confidence, responsibility, and strong character. This hands-on course focuses on real-life skills boys need to succeed academically, socially, and emotionally during this important stage.

In a respectful, structured, and supportive setting, students learn how to stay organized, communicate effectively, and make thoughtful choices—while building confidence and positive peer relationships.

What boys will learn and practice

Middle school survival and readiness skills
Organization, study habits, and academic responsibility
Building and maintaining healthy friendships
Confidence in communication and self-expression
Navigating peer pressure and making wise decisions
Respect, accountability, and personal responsibility

What parents will love

This course helps boys develop self-discipline, confidence, and emotional awareness. Students gain tools they can immediately apply at school and at home, setting a strong foundation for success in middle school and beyond.

Registration & Waiver

Complete all required fields to register for Smart Guy Middle School Club. This form includes the liability waiver.

Session Details

Every Wednesday starting August 12

4:30 PM – 6:00 PM · Snack & Materials included

1. Student Information

Student's Full Name *

Date of Birth *

Age

Grade Entering in Fall

2. Parent / Guardian Information

Parent / Guardian Name *

Relationship to Student

Phone Number *

Email Address *

Do you receive text messages at this number? *

YesNo

Street Address *

City *

State *

ZIP *

3. Emergency Contact

Emergency Contact Name *

Relationship to Student

Emergency Phone *

4. Medical Information

Allergies

Current Medications

Medical Conditions / Special Needs

Physician / Doctor Name

Physician Phone

Emergency Medical Authorization: In the event I cannot be reached, I authorize Charron Academy staff to seek emergency medical treatment for my child if necessary.

5. Photo & Media Release

I give permission for Charron Academy to photograph and/or video record my child during program activities. These images may be used for educational and promotional purposes, including the Charron Academy website and social media.

Payment Instructions

After submitting this form, please send payment via Zelle to 954-496-6098. Include your child's name and course name in the memo.

6. Liability Waiver & Release

RELEASE OF LIABILITY, WAIVER OF CLAIMS, AND INDEMNITY AGREEMENTIn consideration of my child's participation in Smart Guy Middle School Club operated by Charron Academy, I, the undersigned parent or legal guardian, hereby agree to the following:

1. Assumption of Risk. I understand and acknowledge that participation in program activities involves inherent risks, including but not limited to: physical activities, interaction with other students, and exposure to natural elements. I voluntarily assume all such risks on behalf of my child.

2. Release of Liability. I hereby release, waive, discharge, and covenant not to sue Charron Academy, Mrs. Frances Charron, its staff, volunteers, and agents (collectively, "Released Parties") from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, injury, or death that may be sustained by my child while participating in the program or while on the premises.

3. Indemnification. I agree to indemnify and hold harmless the Released Parties from any loss, liability, damage, or cost they may incur due to my child's participation in the program.

4. Medical Authorization. I authorize the Released Parties to obtain emergency medical treatment for my child if I cannot be reached. I agree to be responsible for all medical costs incurred.

5. Behavior Policy. I understand that Charron Academy maintains a respectful, safe environment. My child is expected to follow all rules and instructions from staff. Charron Academy reserves the right to dismiss a student without refund for serious behavioral issues.

6. Refund Policy. Cancellations made 14 or more days before the program start date will receive a full refund. Cancellations made fewer than 14 days before the start date are non-refundable. No refunds will be issued for missed sessions.

7. Acknowledgment. I have read this agreement, fully understand its terms, and sign it freely and voluntarily. I am the parent or legal guardian of the student named in this registration and have the authority to sign this agreement on their behalf.

I have read, understand, and agree to the Liability Waiver and Release above. I confirm I am the parent or legal guardian of the student named in this registration. *

Printed Name of Parent / Guardian *

Signature *

Sign here

Date *

* All fields marked with an asterisk are required.