Online Registation Form K-6 | Glacial Hills Elementary

top of page

Home
Staff
Eaglets Child Care
Resources
Support Us
Shop
More

Use tab to navigate through the menu items.

Student Last Name*

Student Middle Name*

Student First Name*

Student Gender*

Student Birthday*

Entering Grade Level*

If entering PreSchool/PreKindergarten, please select one:

Please only answer this if your student is entering PreSchool or PreKindergarten.

Enrollment Start Date*

Parent/Guardian 1 Name*

Parent 1 address*

Parent 1 address 2*

Parent 1 address 3*

Parent/Guardian 1 Cell Phone*

Parent/Guardian 1 Email Address*

Parent/Guardian 2 Name

Parent 2 address

Parent 2 address 3*

Parent/Guardian 2 Cell Phone

Parent/Guardian 2 E-mail address

Student lives with:*

Student's Previous School

Student has IEP in place

Please only fill out if known.

Emergency Contact #1*

Emergency Contact #2*

Non-Aspirin (Acetaminophen/Tylenol or Ibuprofen) medication will be provided when necessary and only in the case of a low-grade fever.

According to school policy, administration of ANY medication (prescription or over-the-counter) must be requested by written permission from the parent or guardian.

Has your child had any complaints of or treatment for any of the following?

Pollen/Hay Fever

Bee Stings

Food

Animal(s)

Diabetes

Glasses/Contacts

Hearing Loss

Skin Conditions

Seizures

Behavioral

Other

Signature*

Please fill out the Multiple Permission Form next.

(320) 244-3334

610 W 6th St, Starbuck, MN 56381, USA

bottom of page