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Hugger Elementary Kindergarten Registration
Please complete the following information for each child you will be registering. This form will be used during the placement process to help us create balanced classrooms.
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Email
*
Your email
Student Name (First and last)
Your answer
Gender
Male
Female
Other:
Clear selection
My child prefers to be called:
Your answer
Date of Birth
MM
/
DD
/
YYYY
Address (Street, City, Zip)
Your answer
Mother/Guardian's Name and Cell Phone Number
Your answer
Father/Guardian's Name and Cell Phone Number
Your answer
Did your child attend preschool? If yes, where?
Your answer
If you answered "yes" above, how many days a week did your child attend?
2 -3
4
5
Clear selection
Please list any siblings ( Name and Age)
Your answer
What do you view as your child's greatest strengths?
Your answer
Are there any social, emotional, physical or academic issues that may be an area of concern?
Your answer
What does your child like to do in his/her free time? What are you child's favorite toys?
Your answer
What concerns do you have for your child in his/her Kindergarten year?
Your answer
What goals do you have for your child in his/her Kindergarten year?
Your answer
What is the primary language spoken in the home?
Your answer
What holidays does your family celebrate?
Your answer
How does your child feel about coming to Kindergarten? (Please note any trouble separating from a parent.)
Your answer
Please check any of the following that have occurred within your immediate family within the past two years
separation
divorce
death
serious illness
surgery of a child
Other:
Does your child have any medical concerns we should know about? (Allergies, vision, hearing, diabetes, heart conditions, syndromes, asthma, seizures, dietary restrictions, dental appliances, motor restrictions, other)
Your answer
Is your child attending SAC (School Age Care)? If yes, which days?
Your answer
Is your child currently receiving special education services? If yes, please provide additional information.
Your answer
What else would you like me to know about your child?
Your answer
Thank you for completing this survey. We look forward to seeing you soon!
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