2017-18 RCA Student Registration Forms
The Following Questions are to Register Your Students for school at Ridge Christian Academy
Email address *
Estimated Start Date *
Please enter the Day you would like your students to start at Ridge Christian Academy
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Responsible Party *
Please enter the name of the person responsible for all payments
Your answer
Contact Number *
Please enter the contact number for the person responsible for all payments
Your answer
Tax Payer ID
Please fill responsible party's Tax Payer ID (SSN)
Your answer
Address *
Please Enter the Address of the Person Responsible for Payments
Your answer
Student's Address *
Please enter the student's home address
Your answer
Dad's Name *
Please enter Dad/Father's full name
Your answer
Mom's Name *
Please enter Mom/Mother's full name
Your answer
Home Telephone Number
Your answer
Dad's Work Number
Please enter a work number for dad
Your answer
Dad's Cell Number
Please enter a cell number for dad
Your answer
Mom's Work Number
Please enter mom's work number
Your answer
Mom's Cell Number
Please enter a cell number for mom
Your answer
Parent's Email *
Please enter the email a parent will check regularly
Your answer
Emergency Contact *
Please enter who you wanted contacted first in an emergency, if other please include a telephone number.
Student_Name *
Please enter the Name of your oldest student first
Your answer
Student_Grade *
Please enter the Grade Your Student will be entering
Student_DOB *
Please enter your oldest Students Date of Birth
MM
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DD
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YYYY
Student_Gender *
Please Enter your Student's Gender
Student2_Name
Your answer
Student2_Grade
Please enter the Grade Your Student will be entering
Student2_DOB
MM
/
DD
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YYYY
Student2_Gender
Please Enter your Student's Gender
Student3_Name
Your answer
Student3_Grade
Please enter the Grade Your Student will be entering
Student3_Gender
Please Enter your Student's Gender
Student3_DOB
MM
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DD
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YYYY
Student4_Name
Your answer
Student4_Grade
Please enter the Grade Your Student will be entering
Student4_DOB
MM
/
DD
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YYYY
Student4_Gender
Please Enter your Student's Gender
Pick Up List *
Please enter all the people who are allowed to pick up your child(ren). Please use a new line for each name and telephone number
Your answer
PIN Signature *
Please Enter your Pin to sign this document
Your answer
I am a returning student(s) and Need to update my health form
Custody *
Are you in possession of a Custody order
Is your Student 16 Years or older
Please choose a check box if any of your students are 16 years of age or older
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