Scott City Elementary Summer School 2020
Please fill out one form per student. Students that will be in Kindergarten, 1st, 2nd, 3rd, or 4th grade in the 2020-2021 school year should fill out this form. If you will be going into 5th grade then you should fill out the Middle School form. Summer School will be from July 6-30 from 7:40 am - 2:20 pm. *To limit the number of students on buses we highly encourage you to personally drop off and pick up your child. If you need to use bus transportation then it will be provided. ***To ensure bus transportation you must have your registration form submitted by Wednesday, July 1. If you sign up after July 1, please make arrangements to bring your child to school instead of being a bus rider.
Email address *
Student's First and Last Name *
Home address, City, State, MO *
Date of Birth *
Gender *
Ethnicity *
School Child Attends *
This child will be in the following grade for the 2020-2021 school year. *
Parent 1 Name *
Parent 2 Name *
Parent 1 cell number and work number *
Parent 2 cell number and work number *
Parent 1, lives with student *
Parent 2, lives with student *
Morning Transportation *
Morning Transportation if bus rider -please provide the address that your child will be picked up from
Afternoon Transportation *
Afternoon Transportation if bus rider - please provide the address for drop off.
The following people are allowed to pick up my child from school. *
Parents are always our first call. Emergency contacts other than parents. Please include at least two. Names and numbers *
Does your child have a current IEP? *
Health Concerns - Please list any health concerns. If he or she takes medication that will need to be administered at school, you will need to see the nurse to fill out the appropriate forms.
Electronic Parent Consent - By signing my child up for summer school, I am giving permission for him/her to attend all summer school field trips (if we are able to go). I am also giving permission for Scott City R-1 Schools to treat or seek medical treatment if it is necessary. (This includes sunscreen and insect repellent.) *
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