Enrollment Form (2025/26)

Students being enrolled*

Contact Info
Home Address*

Street Address

Street Address 2

CityState / Province

Postal / Zip Code
Email Address*
Cell Number*
DLIGR may occasionally text important information/notifications
Emergency Contact
Emergency Contact #1*

First NameLast Name
Contact Phone Number*
Please enter a valid phone number.
Emergency Contact #2

First NameLast Name
Contact Phone Number
Please enter a valid phone number.
Custody Arrangements
The school must be notified of any custody arrangements and a copy of the custody order/decree must be filed with the school. DLIGR shall not be responsible for enforcing visitation or custody schedules. The school must be notified if there are issues of custody (i.e. permission to visit, pick up, etc.) Are all your children residing with both parents?*

Yes, all students living with both parentsNo, custody arrangements exist
Medical Info
Do any of your children have a medical condition or allergy that the school should be aware of?*

YesNo

Family Physician Info

Please list non-prescription, OTC medications your child may require during the school day.

	Name	Medication	DLIGR authorized to administer?
Student 1
Student 2
Student 3
Student 4
Student 5
Student 6
Student 7
Student 8

Prescription Medication
Do any of your children require prescription medication to be administered during the school day? (If yes, a separate form will be provided)*

YesNo
DISCLOSURE OF IMMUNIZATION INFORMATION AUTHORIZATION

(Full-time students only)
Field Trips
LIABILITY/STUDENT TRANSPORTATION
Liability Insurance Notice: As a matter of principle, DLIGR carries no liability insurance beyond the minimum requirements. The premises are not covered for any liability or loss of property. Staff, students, parents, board members, volunteers, and visitors are at their own risk.
Enrollment Terms
2025/26 Tuition Rates

Rates have been set as follows:

All students (1-12): $2750/student

Kindergarten (25% discount): $2050/student
Agreement
Signature required*

Clear
Should be Empty:

DLIGR Enrollment