2022-2023 Registration Form

Manhattan Catholic Schools Registration Form

Pre-school thru 8th grade / Cardinals Club (ASP) 2022-2023
Registration Fees: The registration fee is $100.00 per student and is due at the time of registration for any student(s) and accompany this form. Other fees will be paid at Enrollment in July. If you would like Cardinal Club (ASP) there is a $50.00 registration fee per child. ALL REGISTRATION FEES ARE NON-REFUNDABLE.

All Enrollment Fees are due by August 5, 2022

All Payment Agreements are due by August 12, 2022
Family Information

This section can be used to transfer identical information to multiple students.
Does this student have siblings that will attend MCS? *

Yes No
Sibling Name(s) and Grade Level(s)
Family Identifier (Multiple family members attending)
If you have multiple students that have repeat information that the office can copy to another registration form, please create or use a unique Family Identifier by entering the youngest students last name and year of birth.
Student Information

KS Statutes require children to be at least five years old on or before August 31st to be enrolled in Kindergarten,
Entering Grade Level *
Student's Full Name *

First Name Middle Name Last Name
Preferred Name
Nickname
Birth Date *

Month Day Year
Date
Gender *
Full-Time Equivalency *
Entry Code *
District of Residence *
School District associated with Residency
Present Address *

Street Address

Street Address Line 2

City State

Zip Code
Mailing Address (if different than street address)

Street Address

Street Address Line 2

City State

Zip Code
Primary Person to contact in case of emergency: *
Parent/Guardian
Relationship *
ex. Father, Mother, etc.
Emergency Contact # *
Primary Physician *
Primary Dentist *
Medical Information *

Allergies Conditions Special Needs None known Food
If any medical information was indicated above, please provide specific details here.
Does the student take medication on a routine basis?
List any medication to be administered at school
* Please refer to MCS Parent/Student Handbook for medication administration policy.

Emergency Contacts

If parents cannot be reached, please notify one of the following:
Emergency Contact #1 *
Emergency Contact #2 *
Emergency Contact #3

Authorized Pick-Up List

*** Please let your child's teacher & the office know if someone on the pick-up list will be picking up your child(ren).   All authorized people on the pick-up list must show picture ID at pick-up time. ***
Will student be riding a USD 383 bus? *

Yes No
After School Provider
Authorized to Pick-Up *
Authorized to Pick-Up
Authorized to Pick-Up

Should be Empty:

Manhattan Catholic Schools Registration Form

Family Information

Student Information

Emergency Contacts

Authorized Pick-Up List