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River Valley Local Schools Kindergarten Registration Form
Kindergarten Registration 2020-2021
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* Indicates required question
Student's Last Name
Your answer
Student's First Name
Your answer
Student's Middle Initial
Your answer
Date of Birth (MM/DD/YYYY)
Your answer
Male or Female
Male
Female
Ethnicity- Please check the box beside the race which the student identifies.
American Indian or Alaska Native
Asia
Black or African American
Native Hawaiian or Other Pacific Islander
White
Clear selection
Student's Address
Your answer
City
Your answer
Zip Code
Your answer
Contact Phone Number
Your answer
Parent/Guardian's (1) Last Name
Your answer
Parent/Guardian's (1) First Name
Your answer
Relationship to Student
Mother
Father
Grandparent
Aunt/Uncle
Legal Guardian
Other
Clear selection
Parent/Guardian's (2) Last Name
Your answer
Parent/Guardian's (2) First Name
Your answer
Relationship to Student
Mother
Father
Grandparent
Aunt/Uncle
Legal Guardian
Other
Clear selection
Who does the student live with?
Mother Only
Father Only
Both Parents
Grandparents
Legal Guardian
Other
Clear selection
Email Address (For future contact.)
*
Your answer
Custody papers are required by law for divorced or separated parents. Do you have appropriate custody papers?
Does not apply (parents married/live together)
Yes
No
Clear selection
What school district do you live in? (District of Residency)
River Valley
Pleasant
Marion City
Elgin
Ridgedale
Other
Clear selection
Does your child have any medical concerns? (i.e. severe allergies, diabetes, etc.)
Yes
No
Clear selection
Submit
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