Royse City ISD

Student Information

* First Name

* Last Name

* Date of Birth:

* Home Phone

* Address

* City

* State

* Zip Code

School for 08-09

Grade Level for 08-09

Parent/Guardian Information

* Father's Name

* Home Phone

* Work Phone

Cell Phone/Pager

* Email Address

* Mother's Name

* Home Phone

* Work Phone

Cell Phone/Pager

* Email Address

Authorization for Emergency Medical Attention

In the event that I cannot be reached to make arrangement for emergency medical attention, I authorize the facility staff or person in charge to take my child to:

Name of Physician

Complete Address

Phone Number

Name of Hospital

Complete Address

Phone Number

* Student Allergy Information

Permission to Release

* Primary Person picking up my child

* Driver's License Number

Please list all persons who are authorized to pick up your child. Your child will only be allowed to leave with the people named. They will be required to show proof of identification. In the event of an emergency, the following persons may also be contacted. Include Name, Relationship, DL #, and Contact Numbers (Please separate with commas):

To add or drop persons form the list, written notice must be given to program staff in advance.

District Employee Discounts

Please complete the discount section if you are applying for a discounted rate. You are eligible to apply if you are an employee of Royse City ISD.

Name

Job Title

Direct Supervisor

Verification

Please denote whether you allow your child to be photographed or video taped.

* Choose:

Yes

My child has the following special needs (regarding academic, social, emotional, etc.)

* Verify Verify


Home Superintendent Leadership School Board Calendars About RCISD Human Resources Departments and Programs Activities Athletics Extended Day Program Weather Community Intranet Web Mail K-12 Planet Campuses	EDP Enrollment Student Information * First Name * Last Name * Date of Birth: * Home Phone * Address * City * State * Zip Code School for 08-09 Grade Level for 08-09 Parent/Guardian Information * Father's Name * Home Phone * Work Phone Cell Phone/Pager * Email Address * Mother's Name * Home Phone * Work Phone Cell Phone/Pager * Email Address Authorization for Emergency Medical Attention In the event that I cannot be reached to make arrangement for emergency medical attention, I authorize the facility staff or person in charge to take my child to: Name of Physician Complete Address Phone Number Name of Hospital Complete Address Phone Number * Student Allergy Information Permission to Release * Primary Person picking up my child * Driver's License Number Please list all persons who are authorized to pick up your child. Your child will only be allowed to leave with the people named. They will be required to show proof of identification. In the event of an emergency, the following persons may also be contacted. Include Name, Relationship, DL #, and Contact Numbers (Please separate with commas): 1. 2. 3. 4. To add or drop persons form the list, written notice must be given to program staff in advance. District Employee Discounts Please complete the discount section if you are applying for a discounted rate. You are eligible to apply if you are an employee of Royse City ISD. Name Job Title Direct Supervisor Verification Please denote whether you allow your child to be photographed or video taped. * Choose: Yes No My child has the following special needs (regarding academic, social, emotional, etc.) * Verify
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EDP Enrollment