2024-2025 SD#10 Student Registration Form
Please fill out all sections of this registration form before submitting. You must submit a form for EACH student at Parkview Elementary School or Dillon Middle School.
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SECTION #1-MEDICAL INFORMATION
We would like to have up to date medical information pertaining to every child in our district to better serve our students. Please complete the form below in sharing any information you feel is vital to the safety of your child while in school.  

THIS INFORMATION WILL BE SHARED WITH TEACHERS AND ADMINISTRATION ON AN AS NEEDED BASIS, BUT WILL REMAIN CONFIDENTIAL. WE ARE ASKING FOR THIS UP-TO-DATE INFORMATION SO ANY DISTRICT #10 STAFF MEMBER CAN PROPERLY TREAT YOUR CHILD IN CASE A MEDICAL ISSUE DOES ARISE. IF YOU HAVE ANY QUESTIONS, PLEASE FEEL FREE TO STOP IN AND/OR CALL CHANNON WILLIAMS AT 406-683-2368.
Email: *
Student's Name: (First and Last) 
(Staff Members Type N/A)
 *
Grade Level in 2024-2025:
(Staff Members Select Staff)
 *
Allergies
(Staff Members Select N/A For Each)
 *
Yes
No
N/A
Does Your Child Have Any Allergies?
Does Your Child Take Any Medication?
If You Marked Yes Above, Please Explain (If You Marked No or N/A to Both Above, Please Skip This Question)
Asthma
(Staff Members Select N/A For Each)
 *
Yes
No
N/A
Does Your Child Have Asthma?
Does Your Child Carry An Inhaler? (If yes, a mandatory medication form needs to be picked up in the office)
Diabetic
(Staff Members Select N/A)
 *
Yes
Not
N/A
Is Your Child Diabetic?
If Your Child Is Diabetic, Briefly Explain Information You Feel Is Needed (Skip This Question If Your Child Is Not Diabetic OR If You Are A Staff Member)
If Your Child Has Had And/Or Continues To Have Seizures, Please Briefly Explain (Skip This Question If Your Child Has Not/Does Not Experience Seizures OR If You Are A Staff Member)
Please Share Any Other Medical Information You Feel Would Be Important For The School To Be Made Aware Of (Type NONE, If There Is No Other Information)
 *
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