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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DD
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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
/
DD
/
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
/
DD
/
YYYY
Student4_Name
Your answer
Student4_Grade
Please enter the Grade Your Student will be entering
Student4_DOB
MM
/
DD
/
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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