WAW Registration Form 2026
Student Name
*
First Name
Last Name
Student DOB
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Grade
*
School
*
Parent/Guardian Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Emergency Contact #1
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact #2
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Allergies
*
Medications
*
Medical Conditions/ Special Needs
*
CHECK ALL THAT APPLY
Participation Permisson
*
YES
NO
Emergency Medical Authorization
*
YES
NO
Photo/ Video Release
*
YES
NO
Transportation Permission
*
YES
NO
Field Trip Permission
*
YES
NO
Parent/ Guardian Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
FOR OFFICE USE ONLY
Priority Family (Red Sticker)
YES
NO
Waitlist
YES
NO
Registration Number
Entered into ProCare by
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