Registration Form2025–2026 Academic Year STUDENT INFORMATION Student Name * First Name Last Name Date of Birth MM DD YYYY Grade Level (2025-2026) * Grade Your Student Will Be Going Into for the 2025-2026 Year. PreK Kindergarten 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th Gender * Male Female Shirt Size * 3T 4T 5T Youth XS Youth S Youth M Youth L Youth XL Adult XS Adult S Adult M Adult L Adult XL Foundations Students (K-4) * Will your Foundations student stay for optional electives after lunch? Yes No Depends on Elective PARENT INFORMATION Parent #1 Full Name * First Name Last Name Relationship to Student * Phone * (###) ### #### Email * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Parent #2 Full Name (if applicable) First Name Last Name Relationship to Student Phone (###) ### #### Email Address Address 1 Address 2 City State/Province Zip/Postal Code Country TUITION PAYMENT PLAN Please choose the best option for your family: * Pay in Full – one payment due August 1 Semester Payments – tuition split into two payments, August 1 & January 5 *A $10 fee per student will be applied for this option Monthly Payments – ten monthly payments, August–May *A $50 fee per student will be applied for this option EMERGENCY CONTACT (Other Than Parent/Guardian) Name * First Name Last Name Relationship to the Student * Phone * (###) ### #### MEDICAL INFORMATION Does your student have any allergies? * Yes No Does your student have any medical conditions we should be aware of? * Yes No Will your student require an EpiPen, inhaler, or other emergency medication on campus? * Yes No Insurance Provider Policy Number (optional) PRIMARY PHYSICIAN INFORMATION Physician Name Office Phone Number (###) ### #### Preferred Hospital (In Case of Emergency) PERMISSIONS & ACKNOWLEDGEMENTS I authorize Oaks Academy staff to contact emergency medical services if necessary. I understand that no medication will be administered on campus unless required by emergency care (e.g., EpiPen or inhaler) with a signed authorization form. I certify that all information on this form is accurate and complete. Parent/Guardian Signature Date MM DD YYYY Thank you for submitting your registration form!
