This form will take about 15-20 minutes to complete.
If you are enrolling multiple students you must fill out this form once for each student.
This enrollment form is a legal document. The information you provide must be accurate and complete. Any personal information requested is solely for the safety and well being of your student. Thank you in advance for your cooperation.
"Custody" is the person(s) who has custody of the student.
This person may not live with the student.
"Lives with" is the person(s) whom the student lives with.
This person may not have custody of the student.
In an emergency, parent/guardians will be called first.
Please provide at least two contacts with phone numbers in addition to parents. All emergency Contacts you list here will have your permission to pick up this student.
Please provide the following information in addition to students immunization and health history. Please list "none" in the spaces provided that do not apply.
Please use the Signatuare Pad below to sign and agree to the following terms:
My signature as parent/guardian of this student allows the above named Emergency Contact(s) to pick up my child from Crater Lake Charter Academy.
My signature also allows emergency medical treatment which may include ambulance transportation and costs, field trip permission, activities and/or athletic participation which includes the regularly scheduled travel and participation required for said participation and the release of information needed for colleges and universities.
My signature also acknowledges that the parent has received notice that they and their child or children are responsible for the expectations listed in the parent/student handbook and school and district rules and policies.
My signature certifies that the information provided on this form is true and correct to the best of my knowledge and that I have read and understand the provided information and expectations.
Parent or Guardian Signature
Please contact our front office
if you have any questions!
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