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
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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