Lake Ridge Elementary

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Registration Form

Lake Ridge Elementary

REGISTRATION CARD

Has the student ever been enrolled in Granite School District?(Required)
Students Legal Name(Required)
Student Gender(Required)
Student's Birthdate(Required)

Race/Ethnicity

Is this student Hispanic/Latino?(Required)
Which of the following groups describe the student's race?(Required)

GENERAL INFORMATION

Student's Home Address(Required)
Does this student reside in a single parent home?(Required)
Does the student have special healthcare concerns?(Required)
Has the student received Special Ed/504 services?(Required)
Does your family come from a refugee background?(Required)

***PARENT/GUARDIAN NAME(S)***

Parent/Guardian Name #1(Required)
Lives With(Required)
Release (Can student be checked out of school by this individual?)(Required)
Parent/Guardian Name #2
Lives With
Release (Can the student be checked out by this individual?)

****PERSON(S) TO CALL IN EMERGENGY WHEN PARENT CANNOT BE REACHED****

Name of Emergency Contact #1(Required)
Name of Emergency Contact #2
Name of Emergency Contact #3
Name of Emergency Contact #4

PREVIOUS SCHOOL ATTENDED

Address

SIBLING IN GRANITE SCHOOL DISTRICT

Sibling Name
Birth Date
Sibling Name
Birth Date
Sibling Name
Birth Date
Sibling Name
Birth Date

FINAL SECTION

Please type your name to indicate the information on this form is accurate.

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