Basehor Elementary Kindergarten Round-Up Initial Form 2020

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Please fill out the following form for Basehor Elementary's Kindergarten Round-Up. Our parent only meeting will be Tuesday, March 24, 2019 at 6:30 in the Basehor Elementary Gymnasium. For kindergarten round-up, your child will attend three half-days on April 1st, 2nd, & 3rd. There are two options for those half-days (morning & afternoon). Please choose a time preference for Kindergarten Round-Up on dates April 1st thru 3rd on the question indicated below. If you have any questions, please feel free to call Basehor Elementary at 913-724-1038 or email mkelly@usd458.org.

Email *

First Name of Child *

Middle Name of Child *

Last Name of Child *

Nickname (Name used most often to refer to your child)

Street Address (Proof of residency, such as a utility bill, will need to be provided to Basehor Elementary.) *

City *

State *

Zip Code *

Date of Birth (Your child must be 5 years old by August 31, 2020.) *

YYYY

Gender *

Female

Male

Prefer not to say

Please list any allergies or medical concerns *

First & Last Names of Parents/Guardians *

Primary Parent Phone Number (xxx-xxx-xxxx) *

Secondary Parent Phone Number (xxx-xxx-xxxx)

Physician's Name *

Physician's Phone Number (xxx-xxx-xxxx) *

Currently, our morning session is closed due to an imbalance with AM & PM. Please choose the afternoon session. Sorry for any inconvenience this may cause. *

Afternoon 1:15 to 3:15

Emergency contact name during round-up dates of April 1st thru 3rd. *

Emergency contact number during round-up dates of April 1st thru 3rd. (xxx-xxx-xxxx) *

Did your child attend preschool? *

Yes

If you answered yes, that your child attended preschool, please type the name of preschool attended.

By clicking on the blue "Submit" button, you will have completed information for Basehor Elementary's Kindergarten Round-Up. Proof of residency within the district will need to be shown at Round-Up. Please plan to attend our Parent Information Meeting on Tuesday, March 24th at 6:30 in the Basehor Elementary Gym. If you have any questions, please don't hesitate to call Basehor Elementary at 913-724-1038 or email mkelly@usd458.org. Thank you!

A copy of your responses will be emailed to the address you provided.

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