Registration 2019 - 2020
Please answer all questions for the above school year. Student records will be saved based on your inputs.
First Name Only *
Students name (PLEASE USE CORRECT CAPITALIZATION and DO NOT PUT MIDDLE NAMES)
Your answer
Last Name *
Students name (PLEASE USE CORRECT CAPITALIZATION)
Your answer
Grade Level *
Grade they are in or going in for the current school year above
Date of Birth *
Month / Day / Year (3/5/81)
MM
/
DD
/
YYYY
Sex *
Street Address *
116 West Willow (PLEASE USE CORRECT CAPITALIZATION)
Your answer
City *
Stockton (PLEASE USE CORRECT CAPITALIZATION)
Your answer
State *
CA (PLEASE USE CORRECT CAPITALIZATION)
Your answer
Zip Code *
95202
Your answer
Phone Number *
(209) 123-1234
Your answer
Authorized Persons to pick up your Children and contact number *
PLEASE SEPARATE THEM BY COMMAS
Your answer
Emergency Contact Person(s) and contact number *
PLEASE SEPARATE THEM BY COMMAS
Your answer
Does your child have any allergies or illnesses we need to know about? *
What are the allergies we need to know about?
Only answer this if you answered yes above
Your answer
Does your Child know about their Allergies
Only answer this if you answered yes above
Physician's name and telephone number? *
Your answer
Fathers First name *
Your answer
Mothers First name *
Your answer
Child lives with *
Do you have any court custody or protection orders in place. *
If yes please provide S.A.I.L. with a copy
I have read and answered all of the above questions to the best of my ability and will come into the school and sign my emergency contact form *
A "No" will result in STAFF contacting you for the missing info.
Do you attend Alpha Omega regularly. *
Fathers Contact Number *
Your answer
Mothers Contact Number *
Your answer
Email Address *
Please enter a valid email so we can send you your confirmation.
Your answer
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