JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Kindergarten Kickstart Registration 2023
This program is for
upcoming
kindergarteners who have registered for the 2023-2024 school year in
PowerSchool
.
It will take place July 17th-27th (Monday- Thursday from 9:00 AM to 12:15 PM
Eastern Time
).
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Which school are you zoned to attend?
*
If you are not sure, please check
HERE
.
Dixie
Ladonia
Oliver
Mt. Olive Primary School
Child's FIRST Name
*
Your answer
Child's LAST Name
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Complete Address
*
Your answer
Guardian's Name(s):
*
Must provide proof that you are the guardian of the child. (Ex. Birth Certificate, Custodial Paperwork, Guardianship Paperwork, etc.)
Your answer
Contact Number 1:
*
Your answer
Contact Number 2:
*
Your answer
Contact Email 1:
*
Your answer
Contact Email 2:
Your answer
Does your child have any allergies or special needs of which the school needs to be aware for Kindergarten Kickstart?
*
Yes
No
If yes, please list allergies or special needs here:
*
Your answer
Does the school have permission to seek medical treatment if unable to reach parents or emergency contacts?
*
Yes
No
Please list the names and phone numbers of individuals to contact for emergencies and individuals other that the guardians who are allowed to
PICK UP
the child. (MUST show Photo ID.)
*
Your answer
I understand that transportation, breakfast, and lunch will not be provided. Parents are responsible for dropping off and picking up the student at the scheduled times. Snacks will be provided but parents may pack additional snacks if needed.
*
Yes, I understand.
No, I do not understand and I will need someone to contact me.
A copy of your responses will be emailed to the address you provided.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Russell County School District.
Report Abuse
Forms
