Bethel Community Education: New Family 24/25 Enrollment Form, Child 1
Bethel Community Education does not discriminate on the basis of race, color, national or ethnic origin.
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Child's Last Name *
Child's First Name *
Child's Middle Initial
Child's Birthday *
Child's Gender *
Child's 2024/2025 Grade Level *
Child's Address (street, city, state, zip) *
Child's Previous School Attended (n/a if not applicable) *
Child's Medical Information (allergies, medical limitations, illnesses) *
Does your child require additional support socially, emotionally, behaviorally, and/or academically? *
If you answered 'yes' or 'uncertain' in the previous question, please explain. *
What additional health and/or medical issues should Bethel Community Education be informed of for your child in order to best support their needs?  *
For Bethel Community Education to administer any medication to your child, you must list specific medication, dosage, time (if applicable), and click "I hereby agree to allow Bethel Community Education staff to administer specific medication (i.e. Tylenol, Motrin, Prescription Drugs, Claritin, etc.) to my child." *
List approved medications not listed above that Bethel Community Education staff can administer. *
Do you have another child to enroll? *
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