Copy of 6th Grade TCMS School Registration Paperwork 2018-2019

Registration & Paperwork for 2018-2019 School Year

This information is required every year for enrollment at TCMS.

Please always remember to contact Ms. Shambaugh, Ms. Kahn and your Grade Level Administrator if any of your information changes, especially your phone number and email address. If your physical address changes you must come into the office and fill out a new student information form (only for 8th grade). Also, if you aren't receiving emails from me, please contact me immediately.

Thank you and see you in August! Have a great summer!

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* 1. Please check the box for your child's grade level that they will enter in 2018 at TCMS.

Grade 6

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* 2. If you have more than one child attending TCMS, you are required to fill this form out again for the other child.

Child's Last Name

Child's First Name

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* 3. Parent/Guardian Information

Mother's/Legal Guardian's Name

Occupation & Employer

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Cell Phone & Contact Phone Number(s)

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* 4. Parent/Guardian Information

Father's/Legal Guardian's Name

Occupation & Employer

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Cell Phone & Contact Phone Number(s)

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* 5. In case of an emergency, please enter the following contacts:

Emergency Contact Name

Relationship to Child

Phone Number

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* 6. In case of an emergency, please enter the following contacts:

Emergency Contact Name

Relationship to Child

Phone Number

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* 7. In case of an emergency, please enter the following contacts:

Emergency Contact Name

Relationship to Child

Phone Number

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* 8. My child takes medication during school hours:

Yes

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* 9. Name of medication (if none please write N/A)

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* 10. Name of Family Physician

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* 11. Preferred Hospital (Recommended: Closest in the event your child is on an out-of-town trip)

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* 12. I (Parent/Guardian) give Terrace Community Middle School permission to take my child on all school-sponsored field trips. Eligibility to attend will be based on acceptable school behavior in all areas and may be withdrawn at teacher/administrator discretion.

It is understood that the above-named student is under the supervision of Terrace Community Middle School and subject to all rules and regulations of the school during all trips.

Should a medical/surgical emergency arise, I authorize the person in charge of this trip to arrange for whatever emergency treatment(s) may be necessary, and to make every reasonable attempt to contact me.

I also release Terrace Community Middle School, its administration, faculty, staff, chaperones and the TCMS Board of Directors from any and all liability and financial responsibility for my student in the treatment for sickness or accident.

I have read this form completely and hereby give my permission for my son/daughter to attend any and all field trips planned by the staff at Terrace Community Middle School that he/she may qualify for.

Parent/Guardian Electronic Signature

Date