Woodland Park Academy Student Information Form
Please complete Emergency Contact information and annual signature requirements. Please complete one form for each of your children.  
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Email *
Student Name (Last, First, Middle Initial) *
Grade Level of Student *
Name of Parent/Guardian-1 *
Parent/Guardian 1  Relationship to Student *
Address (Street & Number) *
City, State, Zip Code *
Phone Number of Parent 1: *
Secondary/Work Phone Number of Parent 1:
Email of Parent 1 *
Name of Parent/Guardian-2
Parent/Guardian 2  Relationship to Student
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Parent 2 Address (Street & Number)
Parent 2 City, State, Zip Code
Phone Number of Parent 2:
Secondary/Work Phone Number of Parent 2:
Email of Parent 2
Student lives with: *
Name/ages of siblings: *
Person other than Parent to be contacted IN EMERGENCY SITUATION when a parent is not available.
Please list in order of which to be contacted.
1. Full Name, Relationship, Primary Phone Number, Secondary/Work Phone Number *
2. Full Name, Relationship, Primary Phone Number, Secondary/Work Phone Number *
3. Full Name, Relationship, Primary Phone Number, Secondary/Work Phone Number *
NAMES  AND PHONE NUMBERS OF PERSONS OTHER THAN PARENT AND THOSE LISTED ABOVE TO WHOM THE CHILD MAY BE RELEASED: (May include older siblings)
NAMES OF PERSONS TO WHOM THE STUDENT MAY NOT BE RELEASED (IF PARENT, YOU MUST PROVIDE DOCUMENTATION)
In case of an emergency school closing (inclement weather, etc) my son/daughter has been instructed to go to the home of: (Name, address, phone number). (PLEASE MAKE SURE THAT YOUR CHILD IS AWARE OF YOUR WISHES)
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