2024-25 TK-6th Grade Pre-Enrollment Form

School Health Record
Does your child have any medical/health conditions that the school should know about?*

NoYes
Comments:

Enrollment Survey
Sex*
Name of Previous School (if your child has not previously attended a school write "none"):*
City of Previous School
State of Previous School
Date first enrolled in US School (if this does not apply, please skip):

MonthDayYear
If, previously enrolled in an academic kindergarten, please list date first entered academic kindergarten (if this does not apply, please skip):

MonthDayYear
Does your child have any siblings that currently attend our school?*

YesNo
If you selected "Yes" to the above question, please list the names of any siblings that attend our school.
Name of Parent or Guardian who is completing this pre-enrollment packet. *

First NameLast Name
Which language do you prefer to be contacted in to complete your child’s registration?*

EnglishSpanish
Legal Consent: By electronically signing below you are agreeing that all the information provided above this signature is correct to the best of your knowledge. Additionally, you agree that your electronic signature is the legal equivalent of your manual/handwritten signature.
Please use your mouse to complete the signature form (or your finger if on smartphone/touch device).
Signature:*

Clear
Date and Time

Final Confirmation
Once this form has been submitted a copy will be sent to the school site.

**Please note: School offices are closed from May 27 to July 16. You will be contacted after the school offices reopen.**

The office will contact you to schedule a time to provide the following important documents for verification:

1) Proof of birth date: One of the following documents is acceptable: birth certificate, recorder sworn transcript, baptismal certificate, physician statement of birth, passport showing age or other valid proof of birth.

2) Proof of Residence: One of the following documents is acceptable:

* Property Tax Payment Receipt
* Rental property contract, lease, or payment receipt
* Utility service (electric, gas, water) contract, statement, or payment receipts
* Voter Registration
* Pay Stub
* Correspondence from a government agency
* Notarized Declaration of residency executed by the parent or legal guardian of a student

3) Immunization Records: Records must be originals, stamped by the doctor's office. The school will make a copy to keep on file, with originals returned to the parent. Parents must present proof that the following immunizations have been completed.

4) Physical Exam: All children need a health check-up prior to starting Kindergarten. The physical exam may be free to those who qualify through the CHDP (Child Health and Disability Prevention) program. For information call 1-800-564-8448. Parents or guardians who do not wish to obtain a physical examination for their child must come to the school office to sign a waiver.
Click here to download a copy of the form

5) Dental Exam: California law (Education Code Section 49452.8) requires that students entering the first year of public school have a dental check-up. Any dental examination completed up to 12 months before the start of Kindergarten will also meet this requirement.

Click here to download a copy of the form
Please click the submit button only once. Within 30-45 seconds you will recieve confirmation of your submittal. Multiple submissions will be submitted if clicked multiple times.
Should be Empty:

SAVANNA SCHOOL DISTRICT

Student Information

Special Services Survey

School Health Record

Enrollment Survey

Final Confirmation