Brandon-Evansville Kindergarten Registration Form 2024

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Brandon-Evansville Kindergarten Registration Form 2024 - 2025

Please complete the entire form before submitting.

Email *

Child's First Name *

Child's Middle Name *

Child's Last Name *

Male or Female *

Female

Male

Date of Birth *

YYYY

Child's Street Address *

City *

State *

Zip code *

Parent/Guardian #1 Name (First, Last) *

Parent/Guardian #1 Relationship to Child:
*

Parent/Guardian #1 Email *

Parent/Guardian #1 Address (if different than Child's address)

Parent/Guardian #1 Phone Number
*

Parent/Guardian #2 Name (First, Last)
*

Parent/Guardian #2 Relationship to Child:
*

Parent/Guardian #2 Address (if different than Child's address)

Parent/Guardian #2 Phone Number:
*

Parent/Guardian #2 Email *

Child's Emergency Contact - Name and phone number (Please list someone other than parent/guardian)
*

Daycare Provider - Name and phone number (If applicable)

Has your child had an early childhood screening?
*

No. (If so, we will be contacting you to schedule a screening for your child.)

Yes. (If so, please provide Brandon-Evansville School with a copy of the screening summary.)

Will this be your first child to attend Kindergarten at Brandon-Evansville? *

Yes

Will your incoming Kindergarten student need district transportation? *

Yes - AM (Home to School)

Yes - PM (School to Home)

None

Other:

Required

If the pickup or drop off address for district transportation is different from the home address (such as a daycare), please include the address below.

Does your child have any health or medical challenges that the district needs to be aware? (including allergies, special diets and medications) *

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