Kindergarten Registration 2008-2009 (page 2) Student Name
Please list local person(s) to be contacted in the event of an emergency when a parent/guardian cannot be reached:
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SACRAMENTAL RECORDS - Please attach a copy of each sacramental certificate
BAPTISM DATE
COMPLETE
PARISH NAME
COMPLETE
PARISH ADDRESS
CHILD RESIDES WITH:
BOTH PARENTS MOTHER FATHER STEPMOTHER STEPFATHER GRANDPARENT
OTHER (PLEASE SPECIFY)
ARE THERE ANY CUSTODIAL ISSUES? YES NO
PLEASE
EXPLAIN
ARE
THERE ANY SPECIFIC CIRCUMSTANCES OUR OFFICE SHOULD BE AWARE OF?
The following requirements have been established for our pilot KINDERGARTEN PROGRAM:
Class
adaptability will be assessed during the first month.
If this environment is not serving your
child’s best interest, a refund will be provided.
Each child must be 5 years of age by October 1, 2008 and begin public school kindergarten in Sept. 2008.
Each child must have previous classroom environment experience (i.e. pre-school).
I ACCEPT RESPONSIBILITY TO ADHERE TO ALL REL. ED. PROGRAM POLICIES INCLUDING THE PARKING LOT POLICIES AT CLASSTIME. I UNDERSTAND IT IS MY RESPONSIBILITY TO INFORM ANY OTHER PERSON RESPONSIBLE FOR MY CHILD’S TRANSPORTATION OF THE REL. ED. PROGRAM POLICIES INCLUDING THE PARKING LOT POLICIES.
I have read the above statements and will adhere to the requirements to the best of my ability.
PARENT/GUARDIAN’S SIGNATURE __________________________________________ DATE
I give permission for my child to be photographed for group
photo displays in the school &/or church/chapel.
YES
NO
PARENT/GUARDIAN’S SIGNATURE __________________________________________ DATE