Registration Form

Registration Form

Complete one registration form per student
Date of Registration*

MonthDayYear
Date
STUDENT INFORMATION
Name*

First NameMiddle NameLast Name
Date Of Birth*

MonthDayYear
Date
Sex*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
GRADE/CLASS INFORMATION
Please Chose One*

New StudentRe-Registration
Grade You Are Registering For*
MOTHER / GUARDIAN INFORMATION
Name

First NameMaiden NameLast Name
Address

Address

Street Address Line 2

CityState

Postal / Zip Code
Email Address
example@example.com
Cell Phone
Place Of Employment
Occupation
Martial Status

MarriedDivorced / SeparatedSingleWidow
FATHER/GUARDIAN
Name

First NameLast Name
Address

Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address
example@example.com
Cell Phone
Place Of Employment
Occupation
Martial Status

MarriedDivorced / SeparatedSingleWidow
SPECIAL EDUCATION INFORMATION
My child receives Special Education Services and has an IEP or a 504:*

YES (please send a copy of the IEP/504 to school office)No
My child receives Special Education Services but does NOT have an IEP or a 504*

YESNO
COMMUNITY INFORMATION

(This information will be used for sacrament preparation and tuition billing)
Religion*
School District*
RESIDENTIAL INFORMATION
Child primarily resides with:*

Mother & FatherMotherFatherGuardian(s)Other
NATIVITY SCHOOL DIRECTORY
Each year, we create a Family Directory for our school that includes each family's basic contact information such as addresses, phone numbers, and email addresses. This is for distribution within our school families only.*

YES, OPT-IN to the Nativity School Family DirectoryNO, OPT-OUT of the Nativity School Family Directory
PHOTO RELEASE INFORMATION
Throughout the school year there will be numerous occasions when we will be contacting local media outlets (newspapers, television, etc requesting coverage for a school event. We also use some of the pictures that we take during the year on our website or social media outlets. The addresses and/or phone numbers of students will never be published. Documents will not include any information that indicate the physical location of a student at a given time other than the attendance at a particular school or participation in school activities.*

YES, I give permission to use my child's picture and nameNO, I do not give permission to use my child's picture and name
ETHNICITY
(This information will not affect registration and will only be used for required state reporting)*

American IndianAlaska NativeBlack/African AmericanAsianNative HawaiianPacific IslanderHispanic/LatinoWhiteOther
LUNCH MONITOR PROGRAM
Each year we require every K-8th grade family to be involved in the Lunch Monitor Program. You will have the option to either monitor once per month from 10:55am-12:40pm or pay a nominal fee. VIRTUS Training is required to monitor. 10 fee will be assessed to your account for any days*

Monitor once per monthOpt-Out of Lunch Monitoring ($100 fee will be assessed to your account)N/A - K Readiness Academy Student only
1st Day of week choice
2nd Day of week choice
REGISTRATION FEE ACKNOWLEDGEMENT
There is a $150 registration fee per student due at time of registration. This payment can be made by cash or check, and can be dropped off to the school office Attn: Isabel Sapio. Registration fees are non-refundable. The registration process is completed when the fee(s) are received.*

I will remit the registration fee(s) to the school office immediately following completion of registration forms. I acknowledge that my child(ren)'s registration applications will not be reviewed/processed without fee(s).
Print Parent / Guardian Name
Parent / Guardian Signature

Clear
There will be capacity limitations for the 2024-2025 school year. As a result, this enrollment application will begin the enrollment process, but acceptance into class is not guaranteed. Any questions or concerns, please email aconnolly@nativityofmaryschool.org. Thank you for your interest in Nativity of Mary School. If we are unable to accommodate your child(ren), any registration fees will be refunded.
Should be Empty:

Registration Form

STUDENT INFORMATION

GRADE/CLASS INFORMATION

MOTHER / GUARDIAN INFORMATION

FATHER/GUARDIAN

SPECIAL EDUCATION INFORMATION

COMMUNITY INFORMATION

RESIDENTIAL INFORMATION

NATIVITY SCHOOL DIRECTORY

PHOTO RELEASE INFORMATION

ETHNICITY

LUNCH MONITOR PROGRAM

REGISTRATION FEE ACKNOWLEDGEMENT