Welcome to our online registration!

Directions for registering your child for Headwaters Academy, After School Care Program and Hub Program.

1.  Read all the documentenation in the links below.  You will be required to confirm that you have read and will comply with the information in the Parent-Child Handbook using the link below.

2.  Fill out all required information in the registration form below. Your registration will not submit if all required fields are not completed.  You will see a confirmation screen if your registration submitted successfully.   Please include any and all information in detail. These forms are the first step towards ensuring that your child’s records are accurate,

3.  After submitting this form there are a couple of steps that still have to take place.

  • Registration Fee will need to be paid.  Registration is not complete until you have submitted your $100 registration fee (per child).

    • — Registration fees will be refunded if your application is not approved.  In the event you are placed on a wait list, you will be notified and we will retain your registration fee to hold your place on the list.

    • — Registration fees can be mailed to our office at 2659 S Chipley Ford Rd.  Please make checks are payable to South River Baptist Church with Headwaters Registration Fee in the memo field.  If you would prefer to pay via checking account, debit or credit card you can use this link > https://onrealm.org/headwaters/give/regfee

  • We will review your Registration and check for availability in your child’s grade level.  If full, you may be put on a waiting list. Enrollments are based on a first-come, first-serve basis.

4.  We will confirm with you via email of your child’s registration status that will include next steps.  If your child cannot be registered, the office will contact you in order to notify you of our decision and the reasons why we have denied registration.

5.  Your Resource Fee will need to be paid in full before your enrollment is confirmed.  A link for payment will be sent in the registration Confirmation email.

6.  If you have any questions, please contact Kim williams at 704-876-1520 ext 112 or kim@southriverbaptist.com. We look forward to enriching your child’s education this year!


  • STUDENT INFORMATION:

  • Note: Pre-K must be at least 4 by 8/31/21 and K must be at least 5 by 8/31/21.
  • After School Care hours are from the end of Headwaters school day, 2:30pm, until 6p Mon-Fri. It will be an additional $185 per month for each child enrolled regardless of how many days they attend.
  • Note: Our HUB program may or may not be offered depending upon need and registration numbers. HUB is designed for 2 to 5 day virtual learners continuing their enrollment in public schools. 1st-5th will be based on a per day cost (min of 2 days) and 6th-12th will be a flat fee per month. Please see Parent-Child handbook for details.
  • Your Monthly Payment may be calculated base on selection as well as availablily for the program.
  • Gender at Birth
  • EMERGENCY CONTACT INFORMATION:

  • FAMILY INFORMATION:

  • PREVIOUS SCHOOL INFORMATION

  • If child was previously in homeschool please list the name of your homeschool. For children that are going into Pre-K or K please list name and address of daycare instead of school, if applicable. If no previous school please put NA.
  • School, daycare or homeschool address
  • Agreement with Fees and Policies

    Links to documents and handbooks where applicable, are included at the top of this form.
  • Fee due with submission of this form (see details at the top of this form for payment options.) Registration is not complete until $100 fee is submitted. ----------------- This registration fee includes one Headwaters T-shirt and one end of year test. Testing is only for children grade 1st-7th.
  • Pre-K $200 per child, K-5th $300 per child, 6th-7th $400 per child and Technology Fee of $50 per child for HUB Program. Resource Fee is due upon registration approval to confirm enrollment in Headwaters Academy.
  • Lump sum fee is Due August 1st and 1st monthly installment is due by August 15th or. The K-7th grade programs are considered a 10 month commitment and the HUB & After School Program is a minimum of 5 month commitment (Aug-Dec and/or Jan-May). Fees per grade are located in the Handbook.
  • Form must be submitted prior to attending 1st day of school
  • Immunization records are required before attending the first day of of school.
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