• REGISTRATION INFORMATION

  • EMERGENCY CONTACT INFORMATION

    Emergency contact if a parent CANNOT be reached:
  • MEDICAL BACKGROUND INFORMATION

  • Please list any allergies your student has (medications, foods, insect stings or bites, etc.)
  • Please list any medications that your student takes on a regular basis. Including OTC medications.
  • Please list any medical disorders, medical history, or special needs or instructions we should know about.
  • INSURANCE INFORMATION

  • Upload image of FRONT SIDE and BACK SIDE of Insurance Card.
    Drop files here or
    Accepted file types: jpg, png, pdf.