College for Kids


Susie Green
Student Programs Specialist


College For Kids Registration Form
Directions: Welcome to College for Kids 2019! It is recommended that prior to completing this registration form, you thoroughly review the Registration Guide and the Course Catalog.
This registration form is organized into seven sections. Upon completion and successful submission of your registration, an email will be sent to you from Grant Wood AEA. This email will provide a link for credit card payment, and details regarding alternate payment options. Student schedules will be emailed within four weeks of registration. Questions may be directed to Susie Green: or 319-399-6775. Thank you!
SECTION 1: Student/Parent Information
* Indicates a required field
*Student First Name
List first name as you would like it to appear on student nametag
*Student Last Name
*Current Grade (2018/2019)
*T-Shirt Size Adult Sizes Only
*Parent/Guardian Last Name
*Parent/Guardian First Name(s)
*Parent/Guardian E-mail
*Re-Enter Email
*Home Street Address
*Current Zip/Postal a valid Zip Code will default City/State
Student E-mail
*Home Phone include area code
Work Phone include area code
Cell Phone include area code
*Emergency Contact Name
*Emergency Contact Phone include area code
*Student is in custodial care of: Both Parents Mother Only Father Only Other
*Car Pooling:
Yes - Our home telephone number and e-mail addresses may be shared with other families for carpooling purposes.
No - We are not interested in carpooling. Do not share our contact information.
*Health Conditions:
Yes - My child has health conditions that College For Kids staff should be aware of. Please explain below:
No - My child does not have any health conditions.
*Waiting List:
Yes - I want to be placed on the waiting list if registration is full at the time this form is received.
No - Do not place me on the waiting list.
*School District
If your district isnt listed select "GWAEA Demo Site" and Building "College For Kids", then put your district and building in the comments.
How did you hear about College for Kids?
Are you interested in receiving emails about other student
programs through Grant Wood AEA and its partners? Yes No
Are you interested in information about scholarships and
future educational opportunities through Coe College? Yes No

SECTION 2: Session Selection & Fees
  1. Select your session dates by checking the appropriate box(es) in the far left column. You may check one or both sessions. Each session runs for two weeks, Monday through Friday.
  2. If you are interested in Early Bird Program, make this selection in the "Fee" column. Then select your top two preferred Early Bird courses using the "Pick Course" buttons. Note: Early Bird space is limited.
  3. If you have received a scholarship discount code from your school, enter it where prompted.
  4. Your total payment due will be calculated. Note that your registration fee includes all class materials (with the exception of lab/supply fees for the Photography classes, which will be billed later).
  5. Upon successful submission of your registration, an e-mail will be sent from Grant Wood AEA. The email will provide a link for credit card payment, and details regarding alternate payment options. Students will not be officially registered into classes until full payment is received.
Session Dates Program/Times Fee Subtotal
Session A
June 17-28Session Full
8:30am - 11:50am
College for Kids
$255 Registration.
Must be received by 04/30/2019
$225 Late Registration.
Received after 04/30/2019
$200 Family Rate*
sibling name
Early Bird (Optional)
$50 Early Bird Classes
Select your preferred Early Bird class here.

College for Kids
STEM Academy
June 25-29
8:30am - 3:30pm

 $225 Tuition
$30 Meal Plan Fee.
(includes cafeteria lunch Monday through Friday)
Session B
July 8-19
8:30am - 11:50am
College for Kids
$255 Registration.
Must be received by 04/30/2019
$225 Late Registration.
Received after 04/30/2019
$200 Family Rate*
sibling name
Early Bird (Optional)
$50 Early Bird Classes
Select your preferred Early Bird class here.

Apparel (Optional)
$10 T-Shirt. Select size and quantity below. T-shirts come in ADULT SIZES ONLY.
S    M    L    XL    2XL    3XL   
Discount Code:
Total payment due


SECTION 3: Course Preferences
To select your courses, follow these directions:
  1. Locate the table below for the session you have selected (Session A: June 17-28 or Session B: July 8-19).
  2. In your session table, click the “Pick Course” button at the end of each row, to select your favorite 6-8 courses in preference order.
  3. To review the course descriptions, the catalog can be found by clicking here: As a reminder, Enrichment students may select from all courses in the catalog. Art students may select from the designated art classes only.) Courses listed in the catalog, but not found via the “Pick Course” buttons below are already full or are no longer available.
  4. If you are registering for both sessions, you may repeat some (not all) of your course selections in both tables. The College for Kids staff will make sure your final schedule does not have any duplicated classes.
  5. If you would like to be placed on the waiting list for a specific course, please include this information in the comment box at the end of the registration form.
  6. If all of your requested courses have been filled prior to receiving your registration, you will be contacted regarding alternative course options, or to receive a full refund.
Following the registration period, a schedule of 3 daily classes (4 daily classes, if registered for Early Bird) will be developed for each student based on his or her 6-8 favorite courses and availability of those courses. Schedules will be emailed within four weeks of registration
College for Kids - Session A: June 17-28 Coe College
ACourse #Course Title

College for Kids - Session B: July 8-19 Coe College
BCourse #Course Title

Section 4: Video/Photo Release for Public Information (Optional)
Note: This form is required for children 18 and under whom Grant Wood AEA wishes to photograph or videotape, either individually or in group settings, for publicity or informational purposes of Grant Wood AEA and its programs. A release from the child's school is not sufficient. This release will be filed in the Communications Office.

I give permission for Grant Wood Area Education Agency and Coe College to photograph or videotape my child(ren), myself and/or my family for use by Grant Wood AEA and Coe College in its publications, websites or promotional literature. I also agree to allow my child’s work to be published by Grant Wood AEA and Coe College in its publications, websites or promotional literature. I give this consent and will make no further claim of any nature.
I understand that I have the right to revoke this authorization at any time, and that I have the right to request and obtain a copy of the recording or photograph. I acknowledge that I have read the foregoing release and authorization, that I understand its terms, and that I am voluntarily signing this release and authorization.
Enter your initials here:

Section 5: Release and Waiver of Liability (Required)
In consideration of my child(ren) being permitted to participate in the College for Kids Summer Enrichment & Art Program, I, on behalf of myself, my spouse and my child(ren), hereby:
1.   Acknowledge that I have reviewed and agree to abide by the Student Expectations for College for Kids.
  • Inappropriate student conduct that causes material and substantial disruption to the education environment, interferes with the rights of others, or presents a threat to the health and safety of students, employees, visitors will subject the student to disciplinary measures. (A threat to others is defined as an act which is intended to cause pain or injury, is intended to result in physical contact which will be insulting or offensive, or is intended to place another in fear of immediate physical contact.)
  • Weapons, other dangerous objects and look-a-likes present a threat to the health and safety of students, employees, and visitors of Coe College, Grant Wood AEA, and the College for Kids Program and are not permitted.
  • Harrassment of students by other students, teachers, or staff of College for Kids will not be tolerated. This includes, but is not limited to, harassment, including bullying, on the basis of race, sex, creed, color, national origin, religion, marital status or disability.
  • Students are expected to remain on the Coe College campus during class time. Prior written authorization from a parent or guardian is required for a student to leave campus.
  • College for Kids, Grant Wood AEA and Coe College reserve the right to involve local police when dealing with behavior that might be considered in violation of the law.
  • Students are expected to arrive on time, participate in all course activities, and show proper respect for teachers, fellow students and for campus property.
  • Regular attendance by students is essential to obtain the maximum educational benefits of the program. Parents and students are encouraged to ensure absence from the program is necessary. Students who are absent for two or more class meetings must have the approval of the director and the instructor to continue with the class. Excused absences include, but are not limited to, illness, family emergencies, recognized religious observations, appointments that cannot be scheduled otherwise, and school/district sponsored and approved activities. In these instances, it is recommended that parents call the College for Kids office to verify the reason for the absence.
  • Directing disrespectful or abusive language at faculty members or other students will not be tolerated. This includes crude or obscene gestures, as well as any language that is delivered in writing, on clothing, on video or audio tapes, or through any other technological delivery system (e.g., voice mail, e-mail, or answering machines).
  • Stealing, vandalizing, or otherwise damaging the property of the school or of school employees, students, or visitors will not be tolerated.
  • Food and beverages may not be consumed in the classrooms. Students in violation of the above stated expectations for student safety and behavior will be subject to removal from the College for Kids program. A refund will not accompany removal from the program.
2.   Release, waive, discharge and covenant not to sue (1) the Grant Wood Area Education Agency, (2) Coe College, (3) Any instructors of the College for Kids Program and (4) any officers, agents and employees of numbers 1, 2, 3, 4 -- all of whom shall be referred to as "Releasees" in this document -- from all liability to me, my spouse, and my child(ren) for any and all loss or damage, and any claim or demands therefore on account of injury, death or property damage, which occurs as a result of my child(ren)'s participation in the College for Kids Program, whether such injury, death or property damage is caused by the negligence, breach of contract or any other legal theory by one or more of the Releasees or otherwise.
3.   Agree that this Release and Waiver of Liability extends to all claimed wrongful acts of Releasees, whether sounding in tort, contract or any other legal theory, and that said Release and Waiver of Liability is intended to be as broad in scope as is permitted by the laws of the State of Iowa.
4.   Agree that in the event any portion of this Release and Waiver of Liability is held invalid, the balance shall, notwithstanding, continue in full legal force and effect to the greatest extent possible under Iowa law.
5.   Acknowledge that I have read this Release and Waiver of Liability, fully understand its terms, understand that I have given up substantial rights by signing it, and have signed it freely and voluntarily without any inducement, assurance, or guarantee being made to me, and I intend my signature below to be a complete and unconditional release of all liability to the greatest extent allowed by Iowa law.
6.   Certify that I have custody or primary physical care of my child(ren) (fill in child(ren)'s names)
* who will participate in the College for Kids Program.
*Enter your initials here:

Section 6: Technology Usage Policy (Required)
Please initial below to grant your child network (internet) access during College for Kids, and to acknowledge that you have read and agree to our Acceptable Use Policy found at
*Parent or Guardian’s Initial:
Please also have your child intial below, indicating that she/he understands, with your guidance, the following statements:
* I have read the expected network etiquette and agree to abide by these provisions. I understand that violation of these provisions may constitute suspension or revocation of Internet privileges.
* I agree to be responsible for payment of costs incurred by accessing any Internet services that have a cost involved.
*Student Initial:

Section 7: Registration Agreement
* I understand that this student will not be officially registered into classes until full payment is received per registered session.
* I understand that all cancellation requests must be done in writing, and I have reviewed the refund policy (see below).

Refund/Cancellation Policy Registrations and materials fees are refundable through May 15, 2019. A $10 administrative fee will be retained. Cancellations must be requested in writing and sent by US Mail or via email. Cancellations received after May 15 will not be eligible for a refund, unless: 1) it is necessitated by an emergency situation, or 2) the space can be filled with a “waiting list” candidate. Students removed from the College for Kids program for violation of student safety and behavior expectations will not receive a refund.

Please provide any additional information or comments regarding this registration below:

Thank you for registering for College for Kids! Upon clicking "Register" below, you will receive an email from Grant Wood AEA titled "Registration Received - College for Kids 2019". Please follow the instructions provided in this email to complete the payment portion of your registration. NOTE: Do NOT click the back button once you have clicked "Register"