Scott City Elementary Summer School Sign Up 2023, Summer School dates: May 22-June 16

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Please fill out one form per student. Students that will be in Kindergarten, 1st, 2nd, 3rd, or 4th grade in the 2023-2024 school year should fill out this form. *Incoming Kindergarten MUST be enrolled at SCE to attend summer school. THERE IS NO OPEN ENROLLMENT FOR INCOMING KINDERGARTEN.

**If you will be going into 5th grade then you should fill out the Middle School form. Summer School will be from May 22 - June 16 from 7:40 am - 2:20 pm.

Email *

Student's First and Last Name *

Home address, City, State, MO *

Date of Birth *

YYYY

Gender *

Male

Female

Ethnicity *

White

Black or African American

American Indian or Alaska Native

Asian

Native Hawaiian or Other Pacific Islander

Required

Select the school that child is enrolled in. *

Scott City Elementary

Kelso C-7

St. Joseph

St. Augustine

Other

If you chose "other" for the above question, then please include the school that your child attends.

This child will be in the following grade for the 2023-2024 school year. *

Kindergarten - MUST be enrolled at SCE to attend summer school. No open enrollment for incoming Kindergarten.

1st grade

2nd grade

3rd grade

4th grade

Parent 1 Name (first and last) *

Parent 1 cell number and work number *

Parent 1, lives with student *

yes

Parent 2 Name (first and last) *

Parent 2 cell number and work number *

Parent 2, lives with student *

Yes

Morning Transportation *

Morning CAR Rider

Morning BUS Rider - if your child is riding the bus please provide the address in the next question.

Required

Morning Transportation ONLY IF bus rider -please provide the address where your child will be picked up.

Afternoon Transportation *

Afternoon CAR Rider

Afternoon BUS Rider - If your child is riding the bus please provide the address in the next question.

Afternoon Transportation ONLY IF bus rider - please provide the address for drop off.

The following people are allowed to pick up my child from school. *

Emergency Contact 1 Name and Number (other than parent). Parents are always our first call. *

Emergency Contact 2 Name and Number (other than parent). Parents are always our first call.

Does your child have a current IEP? *

Yes

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. I am also giving permission for Scott City R-1 Schools to treat or seek medical treatment if it is necessary. (This includes applying sunscreen and insect repellent.) *

By checking this box, I am giving my electronic consent for my child to attend summer school and that I agree to all terms and conditions. I also agree that if my child is running a fever or not feeling well then I will not send them to school.

Send me a copy of my responses.

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