Neta Lane Preschool
4729 Neta Lane, Wichita Falls, Texas 76305, (940) 761-2103
Wichita Christian School Registration
Student Name
For emergency, please contact:
Relative Name Relative Phone
Friend Name Friend Phone
I authorize my child to be released to:
or or
I give permission for my child to go on school-sponsored field trips during the 2003-2004 2004-2005 school year. I understand that my child will travel in a private vehicle driven by a teacher or parent. If I do not want my child to participate in the trip, I will notify the school the day prior to the planned trip.
Parent/Guardian Signature__________________________________________________________________Date____________________________
I give permission for my child to receive emergency medical treatment if necessary from a teacher or administrator of WCS during the 2003-2004 2004-2005 school year. This treatment will be administered only in the event that I cannot be located within a reasonable amount of time following an accident that demands treatment.
My child is physically and mentally able to participate in group activities. My child is participating in an ongoing health supervision program with annual evaluations and scheduled immunization.
Please note any physical problems:
Physician's Name Address Phone
Please attach a copy of your child's immunization record and registration fee with this form and mail to:
Wichita Christian School 4729 Neta Lane Wichita Falls, TX 76302
A 5% discount is applied if paid in full before the first attendance day. A family discount on tuition and registration fees applies with families with two or more children.
Please note: Your child's place in class will be secured upon WCS receiving this form and payment of registration fees. Registration fees will not be refunded or applied to tuition.
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