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ENROLL
APPOINTMENT
Enroll Now
Enrollment Form
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Full Name of Child
First
Last
Date of birth (DD/MM/YYYY)
Gender
Male
Female
Age at Enrollment
Grade Level Applying For
Pre-School (Specify)
Primary (Specify Grade)
Specify Level
Nationality
Home Language
Other Languages Spoken
Primary Parent/Guardian Full Name
First
Last
Primary Parent/Guardian Relationship to Child
Mother
Father
Guardian
Parent/Guardian Phone Number
Parent/Guardian Email Address
Parent/Guardian Residential Address
Parent/Guardian Residential Address 2
Emergency Contact Full Name
First
Last
Emergency Contact Relationship to Child
Emergency Contact Phone Number
Emergency Contact Alternative Phone Number
Child’s Doctor/Clinic
Doctor'svPhone Number
Allergies (food/medicine/environmental)
Chronic Conditions (e.g. asthma, diabetes)
Medications (if any)
Special Needs/Additional Support Required
Denomination/Church Affiliation
Does the child attend Sunday School
Yes
No
Family’s preferred language for communication
Any special faith-based considerations (e.g. dietary observances)
Required Consent: to
Name of Previous School
School Level Completed
Reason for Transfer
Consent: I hereby give consent for my child to participate in all school activities including field trips unless otherwise specified.
Yes
No
Agreement: I understand and agree to abide by the rules regulations and Christian values upheld by Regcos Christian Academy.
Yes
No
Consent: I consent to the school administering first aid and if necessary seeking emergency medical care for my child.
Yes
No
Permission: I grant permission for my child’s photographs/videos to be used in school publications social media and promotional materials.
Yes
No
Date
Submit Enrollment Form
