2025-2026 Shoreway High School Registration
Student Name
*
Student Birthday
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Student Age
Please Select
14
15
16
17
18
19
20
21
We accept students between the ages of 14-21
Student Phone Number
Format: (000) 000-0000.
Student Email Address
example@example.com
Student Address
Street Address
Apt
City
State / Province
Postal / Zip Code
Parent/Guardian or Adult Student Signature
*
Today's Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Student Educational Information
Name of Last School Attended
Last Grade Level Attempted
Please Select
8th
9th
10th
11th
12th
Student Race
Please Select
Asian
Black
White
American Indian
Hispanic or Latino
Biracial
Decline to Answer
Does the student have an IEP or receive Special Services
Please Select
Yes
No
Unsure
Decline to Answer
Main Language at Home Spoken by Student
Please Select
English
Spanish
Other
Decline to Answer
Does the student have a 504 Plan or receive accommodations?
Please Select
Yes
No
Unsure
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Parent/Guardian Information
Required for students 14-17 years of age
Parent/Guardian Name
Not required for students 18 and older
Parent/Guardian Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
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Emergency Medical Form
Emergency Contact Name
Relationship to Student
Please Select
Parent
Guardian
Grandparent
Adult Sibling
Aunt/Uncle
Other
Emergency Contact Cell Number
Consent to Treatment at Closest Hospital
Yes
No
Hospital Name
Please Select
Cleveland Clinic - Marymount
Metro Health
Closest Hospital
Doctor Name
Upload Proof of Residency
Browse Files
Drag and drop files here
Choose a file
Examples: Utility Bill (Gas, electric, water) Lease, Mortgage, Letter from Job and Family Services, Bank Statement
Cancel
of
Upload Birth Certificate
Browse Files
Drag and drop files here
Choose a file
Take a picture of your birth certificate and upload a copy. If you don't have a copy just let us know and we will order one for you.
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of
Submit
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