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SRTest
Registraion
StudentRegistration
Parent or Guardian Name
*
Relationship (to the Student)
*
Address
*
City
*
State
*
ZIP
*
*
Phone
*
Email
*
Confirm Email
*
Emergency Contact Name
*
Emergency Contact Relationship (to the Student)
*
Emergency Contact Phone
*
Emergency Contact Email
*
Confirm Emergency Contact Email
*
Are there any health/medical issues/concerns staff should be aware of (i.e. seizures, asthma, etc)?
Are there any health/medical issues/concerns staff should be aware of (i.e. seizures, asthma, etc)?
False
Are there any health/medical issues/concerns staff should be aware of (i.e. seizures, asthma, etc)?
True
If the student has a food allergy please submit a Special Dietary Needs form. This form can be found
If the student has a food allergy please submit a Special Dietary Needs form. This form can be found
False
If the student has a food allergy please submit a Special Dietary Needs form. This form can be found
True
Is the student currently taking any medication required during summer school hours?
Is the student currently taking any medication required during summer school hours?
False
Is the student currently taking any medication required during summer school hours?
True
If student has a dietary restriction please submit the Special Dietary Needs form
If student has a dietary restriction please submit the Special Dietary Needs form
False
If student has a dietary restriction please submit the Special Dietary Needs form
True
Are there any other health concerns staff should be aware of?
*
Registered
Registered
False
Registered
True
RecordsReleaseConsent
RecordsReleaseConsent
False
RecordsReleaseConsent
True
StudentSurveyRelease
StudentSurveyRelease
False
StudentSurveyRelease
True
PhotoConsent
PhotoConsent
False
PhotoConsent
True
Waitlist
Waitlist
False
Waitlist
True
Student
*
StudentId
*
Name
*
EmailAddress
EmailAddress
False
EmailAddress
True
