NextGen Kids Enrollment Form

NextGen Kids Enrollment Form

SY 2025-2026
Student Information
First Name*
Last Name*
Grade*
FemaleMale
Birth Date*

MonthDayYear
Home Phone*
Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Health Care #*
Doctors Name*

First NameLast Name
Doctors Phone Number*
Format: (000) 000-0000.
Parent/Guardian Information 1
MotherFatherStep-MotherStep-Father
Full Name*

First NameLast Name
Home*
Format: (000) 000-0000.
Cell
Format: (000) 000-0000.
Work
Format: (000) 000-0000.
E-mail*
example@example.com
YesNo
If your address is different than the childs please fill out the info below. Otherwise move onto the next section.
Parent/Guardian 1 Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Parent/Guardian Information 2
Full Name

First NameLast Name
Home
Format: (000) 000-0000.
Cell
Format: (000) 000-0000.
Work
Format: (000) 000-0000.
E-mail
example@example.com
YesNo
If your address is different than the childs please fill out the info below. Otherwise move onto the next section.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Other Infomation
YesNo
YesNo
If yes please list, including any food or drug allergies.
Does your child have any medical conditions?*
Does your child require any medication? If yes, please list these medications.
YesNo
YesNo
Does your child have any siblings attending SCIS?*
If yes, what is their name(s) and grade(s)?
Emergency Contact - Other than Parent/Guardian
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home*
Format: (000) 000-0000.
Cell
Format: (000) 000-0000.
Work
Format: (000) 000-0000.

Adults Authorized for Student Pick-up
Name

First NameLast Name
Name

First NameLast Name
Name

First NameLast Name

Release of Liability
I understand and acknowledge that participation in these activities is completely voluntary and not required by the school for course credit. I also understand and acknowledge that in order to participate in these activities, my child and I agree to assume liability and responsibility for any and all potential risks associated with such participation. Furthermore, I understand, acknowledge, and agree that NextGen Kids, its employees, officers, agents, or volunteers shall not be held liable for any injury suffered by my child as a result of preparing for and/or participating in this program. I confirm that I have carefully read this program’s release of liability, and I understand and agree to all its terms.
Signature*

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CONSENT FOR PHOTOGRAPHS, MOTION PICTURES, AUDIO AND VIDEOTAPES
I hereby provide my consent to NextGen Kids to the utilization of photographs, motion pictures, audiotapes, or videotapes of my child, whether individually or as part of a group. The purpose of this consent is to inform teachers, parents, and the general public about the objectives, activities, or instructional methods of programs operated by NextGen Kids or its affiliated agencies. I understand that these photographs, motion pictures, audiotapes, or videotapes may be shared with local and national audiences and that the photographs may be featured in local newspapers, national publications, or on the Internet, as applicable. It is understood that such media may be captured at any time during the current school year while my child is enrolled, whether it be in the classroom or during activities. Furthermore, I acknowledge that neither I nor my child shall have any ownership, title, or claim over the photographs, motion pictures, audiotapes, or videotapes. Additionally, we understand that we have no cause of action or entitlement to damages or injuries allegedly resulting from the capturing, publication, or dissemination of photographs, motion pictures, audiotapes, or videotapes in the manner and for the purposes outlined herein. It is important to note that signing this release is not a requirement for enrolling my child in any program operated by NextGen Kids.

I hereby verify that I have thoroughly reviewed the Release of Liability, Consent for Photographs, Motion Pictures, Audio, and Videotapes and understand the provisions stated therein. Additionally, I confirm my full agreement with all the terms and conditions specified in the aforementioned sections.
Signature

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PARENT/GUARDIAN HANDBOOK
I understand that the NextGen Kids Parent Handbook is meant to inform families about the policies, procedures, and operational guidelines of the expanded learning program. I recognize the importance of these guidelines for the achievement, safety, and well-being of my student and the corresponding parent/guardian responsibilities. I affirm that it is my responsibility to read the provided handbook. Failure to adhere to the outlined responsibilities, policies, procedures, and operational guidelines may result in the removal of my child from NextGen Kids.
Signature*

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PROGRAM REGISTRATION
Completing the registration form does not guarantee automatic enrollment in the NextGen Kids Program. Your student will be placed on a waitlist, unless already enrolled from the previous school year, and notifications or calls will not be immediate until an opening is available. The order on the waitlist is determined by the submission sequence of the form, homeless youth (McKinney-Vento Act), foster youth, and siblings of students enrolled in the program. Students will be enrolled from the waitlist as openings arise. The program's site lead will contact you when an opening is available for your student.

I hereby verify that I have thoroughly reviewed the Parent/Guardian Handbook and Program Registration and understand the provisions stated therein. Additionally, I confirm my full agreement with all the terms and conditions specified in the aforementioned sections.
Signature*

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NextGen Kids Enrollment Form

Student Information

Parent/Guardian Information 1

Parent/Guardian Information 2

Other Infomation

Emergency Contact - Other than Parent/Guardian

Adults Authorized for Student Pick-up

Release of Liability

CONSENT FOR PHOTOGRAPHS, MOTION PICTURES, AUDIO AND VIDEOTAPES

PARENT/GUARDIAN HANDBOOK

PROGRAM REGISTRATION