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We are so excited to see your child back at Liberty Christian next year! Please fill out the following so we can update our files accordingly.
FAMILY INFORMATION
Father’s Name:_________________________Mother’s Name:__________________________ Marital Status: Married:_____ Separated: ___Divorced:____ Home Address:
____
Second Address if applicable:
____
Home Phone:_____________
Father’s Cell:_____________
Father’s e-mail:
_Mother’s Cell:________________
Mother’s e-mail:___________________________
Father’s Employers:__________________________Telephone:
____
Mother’s Employers:
____
________Telephone:
STUDENT INFORMATION Student's Name:
Date of Birth
gender_______
Grade entering Student's Name:
Date of Birth
gender_____
Date of Birth
gender________
Grade entering Student's Name: Grade entering
OTHER CONTACT INFORMATION Best way to contact parent during day: email: ___ ___________________ text cell: ___ ___________________ phone: ___ ___________________ Emergency Contacts: (name)
(address)
(phone number)
(relationship)
(name)
(address)
(phone number)
(relationship)
Financial Policy All accounts are to be paid by the 15th of each month. A $20 late charge will be added to any account that is not up to date. If there is a problem in keeping an account current, parents should seek assistance with the principal. Every reasonable attempt will be made to work with families having difficulty.
Parents' Response: I have reviewed the financial policy and dress code and agree to support them fully. I also give my permission for my child to take part in all school activities, including physical activities and school sponsored trips away from the school premises. It is required that both parents read the policies and guidelines and both parents sign below. __________________________________________ Father's Signature Date
__________________________________________ Mother's Signature Date