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(Last) (First) (Middle)
Address_______________________________________________ Phone __________________
(Street) (City) (Zip)
Date of Birth_________________ Birth Place__________________________________________
(City) (State) (County)
SS #____________________Grade to Enter_____ If K3 or K4 please indicate: 1/2 day___ all day___
School applicant last attended ________________________________________Grade______
If applicant has repeated a grade, state reason and grade:
Is applicant now or has applicant ever been suspended? ____expelled? _____asked to withdraw? _____
Does applicant have any physical, emotional or mental disabilities that may affect his/her schooling?
_______________If yes, please attach an explanation.
Family Physician ______________________________________________Phone __________________
If the student named herein needs emergency medical treatment, and neither a parent nor the designated
physician can be contacted, consent is hereby granted for such emergency treatment as may be considered
necessary in the opinion of the attending physician.
Signature of Parent/Guardian____________________________ Date____________
Father’s Name_____________________________________ Living with child ____yes ______no
(Street) (City) (Zip)
Phone ____________________ E-MailAddress_______________@______________________
Employer___________________________________________ Phone _____________________
Church Affiliation_____________________________________ Pastor______________________
Mother’s Name_________________________________________ Living with child ____yes ____no
(Street) (City) ( Zip)
Phone ___________________ E-Mail Address____________________@____________________
Church Affiliation______________________________________ Pastor________________________
In signing this application, we acknowledge the following:
1. The administration has full responsibility for placing my child in the proper grade or group.
2. No report card or official transcript will be released to me until all account balances are paid in full and all library books and other school material are returned.
¨ In the event that my child no longer attends CFS, I understand that official transcripts will be sent directly to my child’s next school upon their request and not given to me directly.
3. Unless otherwise specified we give permission for our child to take part in all school activities including sports and school sponsored trips away from the premises.
4. We agree that if our child should become involved in any trouble, or we disagree with any policy set by the school, we will not complain to any other party and in the spirit of meekness will register only necessary complaints with the teacher or leaders involved. Matthew 18:15-17
5. We commit to attend Parent-Teacher meetings and give full support to the total school program.
6. We agree to accept all regulations of
¨ Disciplinary techniques may include but are not necessarily limited to the following: removal from class, having an in-school suspension, an out of school suspension, extra work assignments and other forms of discipline. We understand that the school will not administer corporal punishment.
7. We understand that
8. We hereby pledge to pay all financial obligations to
¨ We understand that overdue accounts may and eventually will result in our child’s not being able to attend CFS.
9. We commit to the policies of
10. We commit to God’s mandate to train up our child/children after the example of Christ and that we support the school in its pursuit of that goal. We hold the school harmless for any liability for any injury or alleged injury to our child. Should legal action, for any reason, be taken against
SIGNATURE OF CONCURRENCE FATHER___________________________________________
SIGNATURE OF CONCURRENCE MOTHER___________________________________________