Passwords must be at least 8 characters long and include at least 1 alpha (A to z), 1 number (0 to 9), and 1 of these special characters: ~!@#$%^&*()"'*+,-/:;<=>?|{}[].

Usernames must be at least 6 characters long.

James River Home School Foundation

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Membership Application

Fill out the form below and click the Continue button at the bottom.

Thank you for considering James River Cobblestones for your children. Please fill out the following application completely. An administrator will contact your references and set up an interview appointment once all information has been received.

Fees for 2025-2026 include: a *non-refundable $70 membership fee per family, and student registration fees of $30 per student for the first 3 students, payable online to the James River Home School Foundation (JRHSF). There is no additional registration fee for 4 or more students.

Tuition payments are not received by the James River Homeschool Foundation. Tuition payments are made directly to instructors. See details in each course description before you register.

*Membership fees are non-refundable UNLESS:

the class you enrolled in is canceled
your application for membership is not approved.

Important notices about weather cancellations are made by text messages. In order to receive these notices, you must check the box underneath your phone number to enable text messages.

If you would rather be on our mailing list and receive notifications of upcoming homeschool events sponsored by the James River Home School Foundation including classes offered by James River Cobblestones, James River Eagles Athletics, and other items of interest to the home school community, we invite you to sign up to be on our mailing list.

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Primary Last Name Primary First Name Primary Email Family Username
Family Password
Confirm Family Password Secondary Last Name Secondary First Name Address City County State / Province Zip / Postal Code Timezone Phone Enable Text Messages

By providing your phone number, you agree to receive transactional and/or informational SMS messages from James River Cobblestones. Message and data rates may apply. Reply STOP to unsubscribe.

Upload Family Photo (Optional) .jpg, .gif or .png

Children

First Name

Last Name

Birthdate

Grade

Student Email/Username

Student Password

If Student Username and Password are both provided, child will have the ability to login.

Child Phone (Optional)

Enable Text Messages

Child is able and agrees to receive text messages at this number.
We understand carrier message and data rates may apply.

Medical Notes/Allergies?
Yes No

Upload Child Photo (Optional) .jpg, .gif or .png

*	Is your child currently enrolled in any other Co-op/Academy or previously attended any home school co-ops, academies, classes, etc?

Yes

*	Has this student ever been suspended from any public or private school, or any homeschool co-op or academy because of discipline problems?

Yes

Add Child

Curriculum/Teaching Style Year you Started Homeschooling Privacy: Include my family information in the membership on-line directory? Yes No

Conversation Emails:

Would you like to receive conversation notifications via email (not just the ones you create)? Yes No

Many Emails: Would you like to receive notifications IMMEDIATELY? Yes No

Delivery Type Whole Thread New Part Only

Daily Digest: Would you like to receive notifications ONCE A DAY? Yes No

Additional Questions

1. Emergency Contact Information (other than a parent or guardian)
List name, relationship, and phone number(s): 2. I certify that we are home-educating in accordance with the following state statute: Virginia Home Instruction Statute – §22.1-254.1
Religious Exemption Statute – §22.1-254(B)(1)
Certified Tutor Provision – §22.1-254(A)
Instructor Registration
3. James River Cobblestones is a Christian homeschool academy operating under the umbrella of the James River Home School Foundation (JRHSF). James River Home School Foundation is a nonprofit Christian organization (501c3) established in 2009 to provide educational and extra-curricular enrichment opportunities for Virginia home-schooled students. One of the goals of the James River Home School Foundation is to offer and organize educational programs that will encourage home-schooled students to strive for academic excellence which we are offering through James River Cobblestones which is currently meeting in Powhatan, VA..

I have read JRHSF's Statement of Faith. I understand all classes will be taught with a Biblical world view. YES
NO
4. I have read the James River Cobblestones Parent and Student Handbook, (hereafter referred to as the Handbook) as well as have explained it to our children. I certify that I consent to and will submit to all governing policies of the James River Home School Foundation, (JRHSF) including all applicable policies in the Handbook; including but not limited to the Parent and Student Expectations, Code of Discipline Policy, and the Dress Code. I understand that this Handbook does not contractually bind JRHSF and is subject to change without notice by decision of JRHSF governing body. I understand that admission to James River Cobblestones is a privilege, not a right, and that any behavior, either on or off campus, which is not consistent with the school's standards could result in the loss of that privilege. YES
NO
5. Please list the name of the church that your family attends. 6. Has your family previously attended or does your currently family participate in any other homeschool organizations, co-ops, academies . . .?

If so, list the organization and years attended.

If not, write N/A. 7. Classes are a full school year committment unless noted otherwise under the class description There will be no refund of membership/registration fees if you withdraw, and no refund of tuition/fees after the second week of classes. Tuition/fees for classes that are for one semester (or less) are due on the first day of class, and there will be no refund after classes have begun. Tution payments are not received by the James River Homeschool Foundation. Tuition payments are made directly to instructors. Tuiton details are posted in each course description. If payments to teachers are more than 30 days late, membership will be suspended, and children may not attend classes until payment in full is rendered to all teachers.

Membership fees are non-refundable UNLESS:

*the class you enrolled in is canceled
your membership application is not approved.

*If a class minimum is not met, the class may be canceled and in that case registration fees would be refunded and membership terminated due to class cancellation.

I have read the above statement and will pay all fees and tuition according to the established deadlines. YES
NO
8. New families must have two character references, from a Pastor, Youth Pastor, Sunday School teacher, a former teacher, coach or current James River Cobblestones member. In the box below, provide names and email addresses for your character references. James River Cobblestones will send them a form to submit by email.

If you are a current member, renewing your memebership, enter the name of your child's teacher(s) and/or the name of another Cobblestones family. 9. A family interview is required as part of the application process. Please select one of the following dates. You will be notified of an exact time by an administrator. July 17, 2025
August 18, 2025
Renewing Member - Interview completed previously
10. Parent involvment is essential to the success of Cobblestones. Please select which team you are most interested in joining. Academic Excellence
Field Trip
Playground Improvement
Prayer Team
Safety Team
Special Events
11. James River Cobblestones has my permission to use photographs taken of my child. NOTE: pictures of students will only be shared on the private member side of the Cobblestones Website and FB closed groups, and in the yearbook. If you do not agree to this you must submit in writing a note stating such. YES
NO I will send a written note.
12.

Release and Waiver of Liability and Indemnity Agreement

I the undersigned (if participant is 18 years of age or older) or parent/guardian of the aforementioned minor participant acknowledge my consent to the following RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT: IN CONSIDERATION for being permitted to enter the premises and participate in any events and/or engage in activities that involve risk or serious injury, including permanent disability or death, which might result not only from their own actions, inactions or negligence, but action, inaction, or negligence of others, the rules of play, or the condition of the premises or of any equipment used and further, that there may be other unknown risks not reasonably foreseeable at this time, assume all the foregoing risk and accept personal responsibility for the damages following such injury, permanent disability or death, and hereby do RELEASE, WAIVE, DISCHARGE, COVENANT NOT TO SUE, AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS, AND ASSUME FULL RESPONSIBILITY FOR, AND RISK OF, BODILY INJURY, DEATH, OR PROPERTY DAMAGE even if determined due to the negligence of the James River Home School Academy (under the umbrella of the James River Home School Foundation), their principals, members, other participants, operators, officials, sponsors, advertisers, owners and lessees of the premises used to conduct the activities and events and each of them, their officers, directors and volunteers, herein referred to as “releasees,” from all liability as a result of participation in the Programs and/or being transported to or from the same, which participation, after careful consideration I hereby authorize, and which transportation I hereby authorize.

I further agree, acknowledge, and certify that he/she: has adequate insurance to cover any injury or damage that may be caused at any event; has no medical or physical conditions which would interfere with his/her participation in any event., inclusive as permitted by the law of Virginia; and that registration to participate with the James River Home School Academy, indicates that the above TERMS and CONDITIONS have been read and voluntarily agreed to.

Furthermore, in the event of any injury or emergency, if I or my alternate emergency contact cannot be notified, I authorize the individual in charge to obtain emergency medical diagnosis and treatment for my child(ren) as deemed necessary by competent medical personnel. I hereby request and authorize any physician, dentist, and staff, duly licensed as Doctors of Medicine, Doctors of Dentistry or other such licensed technicians or nurses, hospital, or healthcare providers to perform any diagnostic procedures, treatment procedures, operative procedures and x-ray treatment, and give emergency medical care and treatment of the above minor. I have not been given a guarantee as to the results of examination or treatment. I authorize the hospital or medical facility to dispose of any specimen or tissue taken from the above-named player. I understand that I am fully responsible for any, and all charges incurred in the event of such treatment and waive all claims or future claims as specified above. (1 required) I certify that I agree with the above waiver.
MEMBERSHIP AND STUDENT REGISTRATION FEES FOR 2025-2026

Cobblestones Family membership fee: $70.00
1st Student Registration: $30.00
2nd Student Registration: $30.00
3rd Student Registration: $30.00

Payment Instructions

Click the following link to pay online with our payment processor, NEWTEK. Remember, you must include payment for all student registrations that apply to your family or they are not considered registered.
James River Home School Foundation (JRHSF)
P.O. Box 574
Powhatan, VA 23139

Payment Options

$70.00 – Family Membership
$30.00 – Student(s) - Please input correct number.

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