Initial Enrollment Form 26/27

Initial Enrollment Form 2026-2027

Please complete as thoroughly as possible. Additional paperwork will be required to complete registration.
STUDENT INFORMATION
Student's Full Name:

First NameMiddle Name (Optional)Last NameSuffix
Sex:
Date of Birth:

MonthDayYear
Date
Grade Entering:
Siblings Name(s) and Age(s):
Has your child ever been expelled?
Does your child require special education or need physical accomodations (optional)?
How did you find out about Kaleidoscope School
Who can we thank for referring you?
What was the event you attended?
PARENT / GUARDIAN INFORMATION
Parent / Guardian 1 Name:

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number
Format: (000) 000-0000.
Work Phone Number
Format: (000) 000-0000.
Parent / Guardian 2 Name:

First NameLast Name
Email
example@example.com
Is the address the same as parent / guardian 1?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone Number:
Format: (000) 000-0000.
Work Phone Number:
Format: (000) 000-0000.
Child primarily resides at:

Other
ONLY MILITARY FAMILIES NEED TO FILL OUT THIS SECTION (Check If Yes):
By signing, I acknowledge that the information above is correct and I have legal authorization to enroll the child.
Parent / Guardian Signature:
Date

MonthDayYear
Date
Should be Empty:

Initial Enrollment Form 2026-2027