K-6 Registration for the 2021-22 School Year2021-22 School Registration K-6Offline
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Family Name *
Address
Address1 * Address2 City * State * Zip *
Telephone *
Phone Type Area Code Number
Child #1
First Name * Middle Name * Last Name *
Preferred Name
Nick Name
Date of Birth *
- -
MM * DD * YYYY *
Grade for 2021-22 School Year *
Child #2
First Name Middle Name Last Name
Preferred Name
Nick Name
Date of Birth
- -
MM DD YYYY
Grade for 2021-22 School Year
Child #3
First Name Middle Name Last Name
Preferred Name
Nick Name
Date of Birth
- -
MM DD YYYY
Grade for 2021-22 School Year
Child #4
First Name Middle Name Last Name
Preferred Name
Nick Name
Date of Birth
- -
MM DD YYYY
Grade for 2021-22 School Year
Father's Name
First Name Last Name
Preferred Name
Nick Name
Religion
Occupation
Employer
Work Phone
Area Code Number Extension
Cell Phone
Area Code Number
Email
Mother's Name & Maiden Name
First Name Last Name
Preferred Name
Nick Name
Religion
Occupation
Employer
Work Phone
Area Code Number Extension
Cell Phone
Area Code Number
Email
Marital Status
If you are divorced or separated, who is the custodial parent?
If you are divorced or separated, are there any court orders in effect for the child(ren) named above?
 
Name of Daycare Provider
First Name Last Name
Telephone
Phone Type Area Code Number
Days of the week your child(ren) are at this day care?
In case of illness and you cannot be reached, should the day care provider be contacted?
 
Name of the parish where you are registered
Where were the child/ren baptized?
 
By signing, I agree all above information is accurate.
Do you agree? Name Date (MM/DD/YYYY)
 
Do any of your children require regular medication? *
If 'Yes', please describe drug treatment
If your child needs to be transported to a hospital, do you give permission for transport? *
Which hospital?
Does your child have any medical conditions (including allergies) we should be aware of? *
If your child becomes ill and you cannot be reached, please indicate whom we should contact. (Name/Phone/Relationship) *
 
It is the policy of all District 750 schools, including Saint Boniface, to transport by school bus all K-6 students. Any student who does not ride the school bus must have written parent permission to walk, bike, or be transported by private individuals to their home or another destination.
Do you give permission for your child to walk or bike to school? *
If 'Yes', a written note is necessary.
Do you give permission for your child to be transported to/from school by another individual? *
If 'Yes', please list the name and relationship of this person/people.
As parents/guardians of the children named on this registration, I accept responsibility for their safety to and from the entrance of the school building. If children named on the registration take the bus, school personnel will supervise them. *
Do you agree? Name Date (MM/DD/YYYY)
My child/children has permission to go on field trips that are planned during the school year. Teachers will notify you as these happen.
We grant permission to have the name or imagine of our child/ren used for school purposes.
 
Family Name *
Last Name
The total cost of tuition for the 2021-22 School Year is $4150 per child.
We commit to
If 'Other', please specify amount
Please select your preferred payment method
We understand that in addition to our financial commitment, our family plans to financially support our parish and assist in fund-raising efforts by volunteering when appropriate. *
Do you agree? Name Date (MM/DD/YYYY)
    1       Review    
 
501 Main Street, Cold Spring, MN 56320
Phone: 320-685-3541
Fax: 320-685-7792
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