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Application for Returning Students
2024 – 2025 APPLICATION FOR REGISTRATION
For Current / Returning Students
Student / Child Information
Student / Child's Full Name
Date of Birth
Child’s Gender
Male
Female
Child's Age on August 1, 2024
Home Address
City
State
Zip Code
Primary Phone Number
Primary E-Mail
Student lives with
(check all that apply)
Father
Mother
Step Father
Step Mother
Guardian
Release information to
(check all that apply)
Father
Mother
Stepfather
Stepmother
Guardian
What's the primary language spoken in the home?
Any other language spoken in the home? To what extent?
Sibling Information (if applicable)
Name
Age
Grade
School
Parent/Guardian #1 Information
Relationship to Child
Name
Address
City
State
Zip Code
Cell Phone
Work Phone
Occupation
Employer
E-Mail
Parent/Guardian #2 Information
Relationship to Child
Name
Address
City
State
Zip Code
Cell Phone
Work Phone
Occupation
Employer
E-Mail
Additional Information
How did you hear about Discovery School?
Person responsible for the tuition payment
Today's Date:
Toddler Program: 18 months - 30 Months
Indicate Choice
8:30 AM - 11:30 AM (Half Day)
8:30 AM - 3:00 PM (Full Day)
Early Childhood Program: 2.5 Years - 6 Years
Indicate Choice
8:15 AM - 11:30 AM (Half Day)
8:15 AM - 3:15 PM (Full Day)
Elementary: Grades 1-6
Indicate Choice
Please submit school records (transcript, report cards, progress reports, test results) for the last two years with applications for elementary
Grade:
Not Applicable
1st
2nd
3rd
4th
5th
6th
Extended Day
Indicate Choice if Available
Not Applicable
Morning Care (7:15 am - 8:00 am)
Afternoon Care (3:30 pm - 5:30 pm)
AM & PM (7:15 am - 8:00 am & 3:30 pm - 5:30 pm)
Medical Information
Physician's Name
Physician Address
City
State
Zip Code
Physician's Phone
Date of Last Physical
Date of Last Hearing Test
Date of Last Vision Test
Date of Last Dental Exam
Parent’s Acknowledgement of Risk & Personal Responsibility
“I acknowledge that I have freely chosen to enroll my child(ren) at Discovery School for the 2024-25 school year. I understand that Discovery School has taken all reasonable precautions to protect parents, students, and staff from exposure to COVID-19. Those measures include, but are not limited to, appropriate screening of families and staff, temperature measurement, face shields, masks, increased social distancing, and enforcement of proper hygiene and sanitization. I am permitting my child(ren) to participate in school activities and programs at Discovery with this understanding and hereby knowingly and voluntarily assume all risks of injury, illness, death or damage related to COVID-19 which may arise as a result of my child’s voluntary participation and attendance of Discovery School. I accept full responsibility for all medical expenses for any injuries or exposure my family might receive by reason of my child's attendance. I am permitting my child(ren) to participate in school activities and programs at Discovery with this understand and hereby knowingly and voluntarily assume all risks of injury, illness, death, or damage related to COVID-19, which may arise as a result of my child’s voluntary participation and attendance of Discovery School. I accept full responsibility for all medical expense for any injuries or exposure my family right receive by reasons of my child’s attendance. I further acknowledge that my child's attendance may expose my family to COVID-19 in spite of the above measures, and I assume any such risk, thus releasing Discovery and all its agents from liability. I may discontinue my child’s attendance at any time in light of the risks I am assuming hereunder, while acknowledging that this attendance in no way impacts or releases me from my contractual enrollment agreement. I also agree that by attending Discovery School, my family will fully comply with all such measures out of respect for the safety and health of the teachers and larger school community. I agree to abide by all safety precautions outlined in the above commitment, to the fullest extent possible, when in public spaces outside of school.”
Type your full name below to agree to the above acknowledgement of risk & personal responsibility:
Parent/Guardian # 2: Type your full name below to agree to the above acknowledgement of risk & personal responsibility:
Application Signing & Acknowledgement
By submitting this application, I certify that all of the information provided is complete and accurate to the best of my knowledge. I confirm that I have legal custody of the child who is applying to attend The Discovery School.
Name of Person Submitting Application (Parent/Guardian)
Date
Signature
Submit Application
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