Student Registration Packet

AUTHORIZATION FOR RELEASE OF RECORDS & INFORMATION
I,Parent/Guardian Name , hereby authorize release of Records/Transcript/Evaluation regarding my child, Student's Name DOB:Date of Birth
From:Previous School/Agency   to the Thomasville City Schools for the following purpose(s):
Check all that apply: Education Programming   Psychiatric Evaluation   Medical   Psychological-Educational Evaluation   Other   Attendance

I understand that I am freely giving my consent to this release of information. I also understand that I have a right to inspect and review all records.
The above information is correct and complete to the best of my knowledge.
Parent/Guardian Signature *

Clear
Date

Month Day Year
Date

Pre-K Registration Form
Child's Name(Exactly as it appears on the birth certificate) *

First Name Middle Name Last Name Suffix(i.e. Jr, Sr, II, III)
Child's Social Security Number: *
D.O.B. *

Month Day Year
Date Of Birth
Sex: *

Male Female
Home Address (Do not enter PO Box Info): *

Home Address

City

County State

Zip Code
Home Phone
Please enter a valid phone number.
If the Student is transferring from another Pre-K, please provide the following:
Previous School Name:
Date

Month Day Year
Date
Parent/Guardian Information
Parent/Guardian #1 *

First Name Last Name
Home Address (IF DIFFERENT FROM CHILD)

Street Address

Street Address Line 2

City State

Zip Code
Home Phone:
Please enter a valid phone number.
Cell Phone:
Please enter a valid phone number.
Email:
example@example.com
Place of Employment:
Work Phone:
Please enter a valid phone number.
Work Address

Street Address

Street Address Line 2

City State

Zip Code
Parent/Guardian #2

First Name Last Name
Home Address (IF DIFFERENT FROM CHILD)

Street Address

Street Address Line 2

City State

Zip Code
Home Phone:
Please enter a valid phone number.
Cell Phone:
Please enter a valid phone number.
Email:
example@example.com
Place of Employment:
Work Number
Please enter a valid phone number.
Work Address

Street Address

Street Address Line 2

City State

Zip Code
Emergency Contact Information(Persons to contact in the event that either parent/guardian cannot be contacted)
Emergency Contact #1
Name
Relationship
Cell Phone
Please enter a valid phone number.
Alternate Phone
Please enter a valid phone number.
Email
example@example.com
Emergency Contact #2
Name
Relationship
Cell Phone
Please enter a valid phone number.
Alternate Phone
Please enter a valid phone number.
Email
example@example.com
I verify the above information to be correct, and I understand that completion of this form does not guarentee placement in a Pre-K class. If my child is placed in Georgia's Pre-K Program, I agree that my child will attend the program for the required number of hours and days as prescribed by the Georgia Department of Early Care and Learning and outlined by the center where my child is enrolled. I understand that failure to comply with these attendance requirements could result in disenrollment. I understand that I cannot register my child without appropriate age documentation.
Signature Parent/Guardian: *

Clear
Date

Month Day Year
Date

Pre-K Registration Form
Child Maintenance
Child's Living Arrangements:

Both Parents Mother Father Other
Child's Legal Guardian:

Both Parents Mother Father Other
The child may be released to the person(s) signing this agreement or to the following:
Name #1
Address
Relationship
Cell Phone
Please enter a valid phone number.
Name #2
Address
Relationship
Cell Phone
Please enter a valid phone number.
Name #3
Address
Relationship
Cell Phone
Please enter a valid phone number.
Name #4
Address
Relationship
Cell Phone
Please enter a valid phone number.
Child's Physician or Clinic's Name(Child's Primary Health Source):
Date of last full health screening:

Month Day Year
Date
Phone Number
Please enter a valid phone number.
My child has the following special need(s):
The following special accommodation(s) may be required to most effectively meet my child's needs while at this center:
My child is currently on medication(s) prescribed for long-term continuous use and/or has the following pre-existing allergies, illness, or health concerns:

Pre-K Registration Form
General Release

I verify the above information to be correct and true. I hearby grant permission for the information provided in the preceding Registration Form to be distributed to Pre-K providers, the Department of Early Care and Learning (DECAL), and certian agencies or those entities contracted by Pre-K providers or DECAL which shall include, but not be limited to, the Georgia Department of Education, and colleges/universities.
Signature (Parent/Guardian) *

Clear
Date

Month Day Year
Date
Photograph/Videotape Release

I hereby grant permission for the Pre-K provider specified below, the Georgia Department of Early Care and Learning (DECAL) and certain agencies or entities contracted by the Pre-K provider or entities contracted by the Pre-K provider or DECAL which shall include, but is not limited to, the Georgia Department of Education, and colleges/universities, to record the participation and appearance of my child, child's name, by photograph and/or videotape in connection with daily Pre-K activities for the purposes of news releases, reporting, and assessing the progress of children and the program. DECAL and its contractors are authorized to exhibit or distribute such photograph(s) and/or videotape in whole or in part without restrictions or limitations for any educational or promotional purpose that DECAL deems appropriate. Such photograph(s) and/or videotape may, for example, appear in printed or visual materials for DECAL and/or on DECAL's web site.
The undersigned hereby jointly and severally releases, acquits, forgives, and discharges the Pre-K provider, DECAL, and other entities contracted by the Pre-K provider or DECAL, from any actions, agreements, claims, controversies, demands, judgements, liabilities, proceedings, and suits, whether arising in equity or in law regarding such participation and appearance by said child.
This shall remain binding upon all successors in the interest and personal representatives of the parties, to the extent permitted by law.
Pre-K Provider Name/Address:
Signature (Parent/Guardian): *

Clear
Date

Month Day Year
Date

Non-Resident Parent Contract

Pre-K through 12
Parental involvement is actively sought by the Thomasville City School District. By enrolling your child in the system, you are promising to provide the necessary support and home environment for a positive educational experience. As a parent/guardian of a Thomasville City Schools student, I support and pledge the following:

1. An early commitment to attendance and punctuality helps develop a sense of responsibility that can transcend a lifetime. Therefore, I pledge to fully support the school’s attendance and punctuality policies.
- My child will attend school every day possible.
- My child will be punctual and will not be signed out unnecessarily.
- I will provide timely, written excuses for all absences.
- When possible, I will provide written notification of any impending absences.
2. I understand that a parent’s role is critical to the educational process. I pledge to fulfill this responsibility in the following ways:
- My child will complete all assigned forms, including homework.
- I will support the development of positive study habits.
- I will attend all conferences requested by the school.
- I will sign and return all progress reports and report cards if requested.
- I will communicate in a respectful manner with teachers and all school personnel.
3. As a parent, I understand that my child’s cooperation and behavior is critical to his/her academic progress. Therefore, I pledge the following:
- I will require my child to show respect for faculty, staff, property and students.
- I will support the school’s student code of conduct.
4. I understand that a non-resident student may be removed from Thomasville City Schools for any of the following reasons:
- Unacceptable behavior (as defined by the Code of Conduct)
- Unacceptable attendance (as defined by the Attendance Policy)
- Lack of effort and/or poor academic performance
- Falsification and/or misrepresentation of information during the application process.
Student Name: Student Name Grade:Grade
Parent Signature *

Clear
Date

Month Day Year
Date

Should be Empty:

Student Registration Packet

MEDICAL HISTORY SURVEY

AUTHORIZATION FOR RELEASE OF RECORDS & INFORMATION

Pre-K Registration Form

Pre-K Registration Form

Pre-K Registration Form

Non-Resident Parent Contract