CAA Religious School Registration

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2023 -2024

Email *

Student name *

Student Birthday

Parent Name *

Public School Grade *

Parent 2 name

Parent 2 Email *

Address *

Parent 1 Phone Number *

Parent 2 Phone Number *

Child lives with: *

Both Parents

Parent 1

Parent 2

Other:

If there is anyone else authorized to pick up your child from school please list their names, relationship to you, and emergency contact number where they can be reached *

Please provide any additional information to help us plan for your child’s return to school (i.e. will not allow child to wear face masks) *

Please help us by describing any emotional, behavioral, physical or learning challenges that might affect the student’s ability to work at grade level or participate in educational or social programs at CAA, or information that might be useful for the educational staff in planning for your child’s education. *

Special Services, Does the student have an IEP or 504 plan *

Yes

If yes a copy of the IEP must be received to the Religious School Office before the start of the school year. *

Describe any special services that the student receives in school or through the school district *

I hereby authorize transport to what Hospital for emergency treatment of my child in the event that I cannot be reached. *

I authorize what Hospital to give emergency treatment to my child in the event that I cannot be reached. *

Is there any other information about your child we should be aware of? *

Use of Pictures *

I hereby give consent for my child’s pictures to be used in school newsletters, posters, newspapers, school website etc

I do not give consent for my child’s pictures to be used in school newsletters, posters, newspapers, school website etc.

Emergency Contact (if parents can’t be reached) Name, Phone Number and relationship to child. *

Parent or Guardian: Sign *

Parent or Guardian: Date *

YYYY

Submit

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