Kindergarten Student Information 2018-2019
Welcome to kindergarten! Please complete all portions of this form so we may pre-register your incoming kindergarten student. You will receive Powerschool access information at a later date so you may complete the online registration process in July. REGISTRATION: July 16th-Online opens... or... July 19th Walk-In from noon-7pm.
School *
Student's First Name *
Your answer
Student's Middle Name *
Your answer
Student's Last Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Street Address *
Your answer
City *
Your answer
Zip Code *
Your answer
Primary Phone Number *
Your answer
Child lives with: *
Required
Father's Name (first, last) *
Your answer
Mother's Name (first, last) *
Your answer
Best Email Address for Communication *
Your answer
Student's Most Accurate Racial or Ethnic Background *
Emergency Contact #1
In case of emergency, please contact:
Name (first, last) *
Your answer
Relationship to Child *
Your answer
Best Phone Number to Call *
Your answer
Emergency Contact #2
Name (first, last) *
Your answer
Relationship to Child *
Your answer
Best Phone Number to Call *
Your answer
List Any Medical Conditions/Allergies (if student does not have any medical conditions or allergies please write none) *
Your answer
**In case of an emergency, and I or a member of my family cannot be contacted, I give my permission for the school authorities to seek medical treatment for my child, and I assume responsibility for such emergency expenses.** *
Please Enter Your Name (serves as electronic signature) *
Your answer
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