2024 Elementary Extended School Year Registration/Medical Form
Complete and submit this form  to enroll your child in our Elementary Extended School Year program. Complete one form for each child being enrolled.  
Student's Last Name *
Student's First Name *
Student's Current Grade (2023-2024 School Year)
*Must be enrolled in an OCS school and attend school 
 *
Student's Current School *
Student's Homeroom Teacher *
Parent/Guardian Name *
Parent/Guardian Current Email
Current Street Address *
Phone Number *
Alternate Phone Number *
Emergency Contact Name *
Emergency Contact Phone Number *
Allergies/Medical Information *
Special Needs *
Week(s) that your child will attend the Extended School Year program. (Check all that apply.) *
Jāaizpilda obligāti
Transportation *
Please list the name and phone number of those permitted to pick up your child.  (These people will be required to show identification.)
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