New Student Registration and Emergency Medical Authorization
New Student On-Line Registration: Kindergarten - Grade 12
What School Year will your student start at CCS? *
Your answer
The School District your student are currently attending. *
Your answer
What grade will student be entering Calvert Catholic Schools? *
Required
Student First Name *
Your answer
Middle Name~ Does not apply, write NA *
Your answer
Last Name *
Your answer
Gender *
Birthdate *
Your answer
Birth Place *
Your answer
Ethnicity *
Required
Address *
Your answer
City, State, Zip *
Your answer
Resident County *
Required
Home Number *
Your answer
Family Parish *
Required
Is Student Baptized? *
Required
Where Was Student Baptized? Does not apply, write NA in box *
Your answer
Indicate the School District Student lives in
Will your child ride the bus? *
Required
If yes, Which bus? *
Required
Resident County: *
Required
EMERGENCY MEDICAL AUTHORIZATION
I Hereby Give Consent For The Following Medical Care Providers And Local Hospital To Be Called
Student Emergency Treatment: I want my Child to be transported to following hospital *
Student Doctor Information
Student Dentist Information
Mecial Specialist Name and Phone Information: ~ Does not apply, write NA in box *
Your answer
MEDICAL FOR SCHOOL INFORMATION
PLEASE list all health problems or concerns (Example: asthma, diabetes, seizure disorder, heart condition etc.)
Please write Medical Alerts and Conditions below: ~ Does not apply, write NA in box *
Your answer
Please list Medications your student being taken: ~ Does not apply, write NA in box *
Your answer
Please list any major illness, surgery, or injuries: ~ Does not apply, write NA in box *
Your answer
Allergies List all (Example: food(s), bee sting, etc.) ~ Does not apply, write NA in box *
Your answer
Has your child has been instructed by his/her Physician to use inhaler? *
Required
Authorization of Inhaler form is available at www.calverths.org. Please complete and return Inhaler forms to Calvert High School Office.
Parent Information
Mother First and Last Name: *
Your answer
Mother Addess *
Required
Mother City, State and Zip *
Required
Mother Maiden Name *
Your answer
Mother Phone Number Home ~ Does not apply, write NA in box *
Your answer
Mother Cell Number ~ Does not apply, write NA in box *
Your answer
Mother Work Number ~ Does not apply, write NA in box *
Your answer
Mother Place of Employment~ Does not apply, write NA in box *
Your answer
Mother Occupation~ Does not apply, write NA in box *
Your answer
Mother Primary Email ~ Does not apply, write NA in box *
Your answer
Mother Work Email ~
Your answer
Status of Mother *
Required
Mother If Divorced: Custody Arrangements *
Required
Step Father Name
Your answer
Step Father's Cell Number
Your answer
Father First and Last Name *
Your answer
Father Address ~ Does not apply, write NA in box *
Father City State, Zip *
Required
Father Home Number~ Does not apply, write NA in box *
Your answer
Father Place of Employment~ Does not apply, write NA in box *
Your answer
Father Occupation~ Does not apply, write NA in box *
Your answer
Father Cell Number Does not apply, write NA in box *
Your answer
Father Work Number ~ Does not apply, write NA in box *
Your answer
Father Primary Email ~ Does not apply, write NA in box *
Your answer
Father Work Email ~ Does not apply, write NA in box
Your answer
Status of Father *
Father If Divorced: Custody Arrangements *
Required
Step Mother First and Last Name
Your answer
Step Mother Cell Number
Your answer
Additional Emergency Contact Person
Relationship with student *
Contact Person Name:
Your answer
Contact Person Home Number~ Does not apply, write NA in box
Your answer
Contact Person Cell Number~ Does not apply, write NA in box *
Your answer
Contact Person Work Number~ Does not apply, write NA in box *
Your answer
Additional Information
I agree to allow Calvert Catholic Schools to transport my child for school field trips, events, and in case of emergency situations. *
I acknowledge that I am responsible for reading and understanding all school policies, procedures, and expectations as outlined in school handbooks and policy manuals. *
Policy Acknowledgement Agreement-Student-Parent Handbook-Technology Handbook-Athletic and Extracurricular Handbook-Safety Procedures Handbook
I will review the following documents and before and throughout the course of an academic year and note any updates in school policy. I am aware that these documents can be found on the school website under the "Information" dropdown menu. *
Updates and Revisions-Weekly Newsletter-Classroom Newsletters -SchoolMessenger Notifications -Etc.
I will review the above documents before the start of each academic year and note any changes in school policy. *
I agree to allow Calvert Catholic Schools to use photos / videos of my child to promote the school in various forms, including, but not limited to, the school website, school social media, local newspapers and publications, billboards, etc. *
Who is Responsible for Paying Tuition: *
Required
Do you wish to use SchoolMessenger Instant Alert System? *
Submit
Never submit passwords through Google Forms.
This form was created inside of Calvert Catholic Schools. Report Abuse - Terms of Service