STUDENT REGISTRATION FORM PreK-12 - Lexington Public Schools
STUDENT REGISTRATION FORM PreK-12 - Lexington Public Schools
STUDENT REGISTRATION FORM PreK-12 - Lexington Public Schools
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10. Custodial Parent(s)/Guardian Information:First Name Last Name Relationship to Student( ) ( )Address Home Phone Cell PhoneEmail address ( )Business PhoneFirst Name Last Name Relationship to Student( ) ( )Address Home Phone Cell PhoneEmail address ( )11. Non-Custodial Parent(s)/Guardian Information:Business PhoneEmail addressFirst Name Last Name Relationship to Student( ) ( )Address Home Phone Cell or Business PhoneEmail addressFirst Name Last Name Relationship to Student( ) ( )Address Home Phone Cell or Business Phone<strong>12</strong>. Family Doctor: Telephone: ( )13. Family Dentist: Telephone: ( )14. Emergency Contact (If parent/guardian can not be reached, OR can not speak English)Emergency Contact: 1. Home Phone: ( )(This should be someone who would be responsible for the child in the parent’s absence, other than the parent.)Relationship to student Cell Phone: ( )Emergency Contact: 2. Home Phone: ( )(This should be someone who would be responsible for the child in the parent’s absence, other than the parent.)Relationship to student Cell Phone: ( )15. Student Email address (high school students only)Comments:2.1.20<strong>12</strong>
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