Kindergarten Student Information for 2018-2019
Welcome to kindergarten! Please complete all portions of this form so we may pre-register your incoming kindergarten student. You will be able to officially register students this summer. In July you will receive in the mail online access information. REGISTRATION: July 16th - Online opens . . . or . . . . July 19th - Walk-In from noon - 7 p.m.
Email address *
'School Boundary' in which you live *
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 *
Where student resides.
Your answer
City *
Your answer
Zip Code *
Your answer
Primary Phone Number (xxx-xxx-xxxx) *
Your answer
Child lives with: *
Check all that apply.
Required
Does your child have any siblings that will also be attending JBS next year?
If Yes please list here. If NO just leave blank.
Your answer
Father's Name *
Biological Father's First & Last Name
Your answer
Mother's Name *
Biological Mother's First & Last Name
Your answer
Best Email Address for Communication *
For more than one address separate with a comma.
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 (xxx-xxx-xxxx) *
Your answer
Emergency Contact #2
Name (first, last) *
Your answer
Relationship to Child *
Your answer
Best Phone Number to Call (xxx-xxx-xxxx) *
Your answer
List Any Medical Conditions/Allergies (if this does not apply write NONE) *
Your answer
I have checked and updated all contacts and phone numbers, and 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. *
You will be able to update and add more contacts once you officially register your child this summer.
Did your child attend a preschool program? If 'YES' please write the name of the program in this section. If not write 'NO'. *
Your answer
Please Enter Your Name Here (serves as electronic signature) *
Your answer
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