Student Registration Form
Please fill out one per student.
STUDENT INFORMATION
Last Name
First Name
Date of Birth:
-
Month
-
Day
Year
Date
What grade is your student going into the fall?
Please Select
Junior Kinder (must be 4 by September 1st)
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Gender:
Male
Female
If a Foundations Student (K-4th), will they stay for optional electives after lunch?
Yes
No
What is your student's shirt size?
Please Select
3T (Toddler)
4T (Toddler)
5T (Toddler)
XS (Youth)
S (Youth)
M (Youth)
L (Youth)
XL (Youth)
XS (Adult)
S (Adult)
M (Adult)
L (Adult)
XL (Adult)
XXL (Adult)
Each student will receive one free school shirt.
PARENT/GUARDIAN INFORMATION
Parent/Guardian 1
Full Name:
Relationship to Student:
Phone Number:
Format: (000) 000-0000.
Email Address:
example@example.com
Parent/Guardian 2 (if applicable)
Full Name:
Relationship to Student:
Phone Number:
Format: (000) 000-0000.
Email Address:
example@example.com
EMERGENCY CONTACT
(Other Than Parent/Guardian)
Full Name:
Relationship to Student:
Phone Number:
Format: (000) 000-0000.
Back
Next
PERSONAL MEDICAL INFORMATION
Does your student have any allergies?
Yes
No
If yes, please list:
Does your student have any medical conditions we should be aware of?
Yes
No
If yes, please explain:
Will your student require an EpiPen, inhaler, or other emergency medication on campus?
Yes
No
If yes, please describe:
PERMISSIONS & ACKNOWLEDGEMENTS
I authorize Oaks Academy staff to contact emergency medical services if necessary.
I understand that no medication will be administered on campus unless required by emergency care (e.g., EpiPen or inhaler) with a signed authorization form.
I certify that all information on this form is accurate and complete.
Parent/Guardian Signature:
Date:
-
Month
-
Day
Year
Date
Submit
Should be Empty: