Enrollment Application - Great River Christian School

ENROLLMENT AGREEMENT

Please answer the following enrollment questions:

We are a new family to Great River Christian School?

Yes
No

I understand and commit to the following statement:

Yes
No

Great River Christian School reserves the right to deny or discontinue enrollment due to student or parent behavior; student or parents not in alignment with school policies/procedures/philosophies; students or parents not in alignment with the school’s statement of faith and closely-held religious beliefs; and/or any other situation or circumstance, as determined by the On-Site Administrator or Board of Directors.

Enrollment Agreement

Yes
No

I affirm that I have read the entire Enrollment Agreement, understand it, and agree to follow it. I truthfully meet all of the requirement for admission of my children to Great River Christian School.

ADMISSION REQUIREMENTS

Our school’s admissions requirements are designed to help everyone understand what is important at Great River Christian School (GRCS) so that we can do everything possible to remain true to our faith and beliefs. We want you to clearly understand what it means to be part of the GRCS community. In order to enroll children at Great River Christian School, at least one parent/foster parent/guardian must agree to the following statements:

I/we have a clear testimony of personal faith in Jesus Christ as Savior and Lord.

Yes
No

I/we are member(s) or regularly worship in a local Bible-believing church.

Yes
No

I/we affirm to the Great River Christian School Statement of Faith.

Yes
No

I/we agree to not participate in practices that would be considered illegal or immoral or inconsistent with a positive Christian lifestyle.

Yes
No

I/we will adhere to the policies and procedures of GRCS.

Yes
No

Signature (leave blank-sign in school interview)

Parent/Guardian Name

First

Last

Date

Parent/Guardian Information

First Parent/Guardian Name

First

Last

Relationship to student(s):

Custodial Rights:

Yes
No

Marital Status

Financial Responsibility

Yes
No

Current Church

Parent/Guardian Phone

Parent/Guardian Email

Occupation/Work Phone

Second Parent/Guardian Name

First

Last

Relationship to student(s):

Custodial Rights:

Yes
No

Marital Status

Financial Responsibility

Yes
No

Current Church

Parent/Guardian Phone

Parent/Guardian Email

Occupation/Work Phone

Household Information

Parent 1 Address

Address Line 1

Address Line 2

City

State

Zip Code

Parent 2 Address (If Different)

Address Line 1

Address Line 2

City

State

Zip Code

Is your child eligible for Free/Reduced lunches?

Yes
No

Student Demographic Information

Student 1 Full Name

Preferred Name

Student 1 Date of Birth

Local School District of Residence

Student 1 Gender

Male
Female

Student 1 Ethnicity

Student 1 Race

Student 1 Birth City, State, Country

Student 1 Cell #

Student 1 Email

Student 2 Full Name

Preferred Name

Student 2 Date of Birth

Local School District of Residence

Student 2 Gender

Male
Female

Student 2 Ethnicity

Student 2 Race

Student 2 Birth City, State, Country

Student 2 Cell #

Student 2 Email

Student 3 Full Name

Preferred Name

Student 3 Date of Birth

Local School District of Residence

Student 3 Gender

Male
Female

Student 3 Ethnicity

Student 3 Race

Student 3 Birth City, State, Country

Student 3 Cell #

Student 3 Email

STUDENT RECORDS REQUEST FOR TRANSFER

We will request a records transfer for all NEW to GRCS students in 1st—12th grades. Please list the last school attended and the address so we may request academic & personal records.
Thank you in advance for your help.

School Name

Office Phone

Office Email

School Address

Address Line 1

Address Line 2

City

State

Zip Code

STUDENT DISCIPLINE / SUSPENSION / EXPULSION

Have any enrolling students ever been suspended/expelled from another school?

Yes
No

If yes, please list student name and explanation:

PUBLICATIONS RELEASE

Social Media

Yes
No

Great River Christian School has permission to use my student(s) name(s) and/or picture(s) in GRCS publications, social media outlets and/or the website.

Publications

Yes
No

Great River Christian School has permission to use my student(s) name(s) and/or picture in public newspaper publications.

FIELD TRIP CONSENT

I/We, the parents/guardians of the children attending GRCS listed on the front of this form, give permission for said children to participate in any field trip (in a vehicle or walking) sponsored by Great River Christian School and supervised by GRCS personnel. I give permission for my child(ren) to receive medical treatment in the unlikely event of an accident or emergency. I understand that every effort is made to ensure the safety of our students and realize there is an element of risk in any kind of trip or activity. I will not hold Great River Christian School or any of the staff and chaperones liable for any injury that could occur.

Signature (leave blank-sign in school interview)

Parent/Guardian Name

First

Last

EMERGENCY CONTACTS – OTHER THAN PARENTS

Name

First

Last

Phone

State, Student Email

Relationship to Student

Name

First

Last

Phone

Relationship to Student

Name

First

Last

Phone

Relationship to Student

PEOPLE WHO ARE ALLOWED TO PICK UP CHILD(REN)- NAME AND PHONE #:

PEOPLE WHO ARE NOT AUTHORIZED TO PICK UP MY CHILD(REN):

Jeremiah 29:11 – “For I know the plans I have for you,” declares the LORD, “plans to prosper
you and not to harm you, plans to give you hope and a future.”

ENROLLMENT AGREEMENT

ADMISSION REQUIREMENTS

Parent/Guardian Information

Household Information

Student Demographic Information

STUDENT RECORDS REQUEST FOR TRANSFER

STUDENT DISCIPLINE / SUSPENSION / EXPULSION

PUBLICATIONS RELEASE

FIELD TRIP CONSENT

EMERGENCY CONTACTS – OTHER THAN PARENTS

Jeremiah 29:11 – “For I know the plans I have for you,” declares the LORD, “plans to prosper you and not to harm you, plans to give you hope and a future.”

Thank you for choosing Great River Christian School

Jeremiah 29:11 – “For I know the plans I have for you,” declares the LORD, “plans to prosper
you and not to harm you, plans to give you hope and a future.”