Summer School 2019 Busing, WIN, Interventions, Emergency Information Pre-Registration for students who are new to Camp Sparta or who can't access Skyward

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This form is the first part of the registration process for summer school. It takes the place of the walking field trip permission slip, busing registration, WIN registration, intervention request, and emergency information form. Please complete this required form first. When you submit this form, you will be taken to a page that will give you instructions on the actual registration process. Thank you. Contact wbernett@spartan.org with questions.

Email *

Student Last Name *

Student First Name *

Student Date of Birth *

YYYY

Name of person completing this form *

Parent/Guardian Last Name *

Parent/Guardian First Name *

Parent/Guardian Email Address *

Home Address *

Parent/Guardian Daytime Phone Number *

Parent/Guardian Alternate Phone Number *

Are the phone numbers above good for emergency contact during summer school? *

Yes

If no, what number should we use for emergency contact?

Which school will your student attend in the fall? *

PreK Charter

Montessori PreK

Cataract

Lakeview Montessori

Lawrence-Lawson

Maplewood

Southside

Meadowview Intermediate

Meadowview Middle

HighPoint

Innovations STEM

Sparta High School

SAILS

St. Pat's

St. John's

Other:

Would you like your student to be considered for registration in interventions in math or reading? (For students entering grades K-8) *

Math

Reading

Both

No, thank you

Who is your student's current teacher? (If student is a middle or high school student, please note that here.) *

Grade student will be entering in fall 2019 *

Is there any medical information we need to know? If so, please note it here along with any treatment information we may need.

What is the name and location of your student's doctor? *

What type of insurance do you have? Please include your insurance card number. *

Does your student have permission to participate in summer school walking field trips?(If no, student may not be able to participate in some classes.) *

Yes

If any of your student's class choices and alternates are full, would you like us to choose an available class for them or leave that session empty? *

Choose an alternate that is similar to their other choices

Leave it empty

If yes, who has permission to pick up your child at 3:30 other than the people listed at the top of this form? (Please list name and phone number if not listed above.) If your student can walk or ride their bike at the end of the day, please also note that.

Does your student need busing? *

Yes

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