RM_StatsSTUDENT INFORMATIONStudent Last NameStudent First NameMiddle NameDate of BirthGender Male Female Grade (Fall of 2023)Select an optionK123456789101112Grade Street AddressCityStateZipStudent Cell PhoneStudent Email Family InformationMarital Status Single Married Divorced Separated Parent Email *FatherFather Last NameFather First NameFather AddressFather CityFather StateFather ZipFather CellFather's EmailFather EmployerFather Work Phone MotherMother Last NameMother First NameMother AddressMother CityMother StateMother ZipMother CellMother's EmailMother EmployerMother Work Phone Who Does Student Live With? (Select All that Apply) Mother Father Step-Father Step-Mother Guardian Step-Parent NameStep-Parent AddressStep-Parent PhoneStep Parent EmailGuardian Last NameGuardian First NameGuardian CellGuardian EmailGuardian AddressGuardian CityGuardian StateGuardian ZipGuardian Work PhoneDay Care ProviderDay Care Provider Phone Number Church AttendanceStudents attending Williston Trinity Christian School are strongly encouraged to attend church regularly. Our purpose is to help Christian youth grow in the grace and knowledge of the Lord Jesus Christ according to 2 Peter 3:18. Faithful church attendance helps create a balance in life and allows the students to see life from God’s point of view.Church Attendance Weekly Monthly Occasionally Church Attended EMERGENCY CONTACTEmergency Contact 1Relationship to StudentPhone NumberEmergency Contact 2Relationship to StudentPhone NumberAdditional Report CardsAdditional copies of report cards, school reports, etc. can be mailed to:NameRelationshipPhone NumberMailing Address Are there restrictions on who can pick up your child up from school? Please Select One Yes No If so, then whom?Is there currently a court-ordered document preventing your child from seeing anyone? Please Select One Yes No If so, please provide the office with a copy of the document upon registering your child.In the past 12 months, has the student had disciplinary difficulties, been suspended from school, or been in trouble with the law? Please Select One Yes No If so, please explainHas your child ever been tested for or is currently receiving any of the following: Please Check All That Apply None Title I LD Speech IEP/IPS MedicalAllergiesGlasses / Contacts Yes No Hearing Aids/Accomodations Yes No Is Dental retainer required? Yes No Ethnicity: Is the student Hispanic or Latino? Yes No RaceSelect an optionAmerican Indian or Alaskan NativeAsianBlack or African AmericanNative Hawaiian or other Pacific IslanderCaucasianOtherPermissionsField Trip Permission: We hereby grant permission for our child to be taken on field trips, outings, competitive athletic events, choir tours, or other extra-curricular activities. We grant the staff or agents of Williston Trinity Christian School (WTCS) permission to seek emergency medical services for my child if the need arises while at school or school-related activities. Yes No Photography Permission: I grant WTCS the right to take photographs of my child. I authorize WTCS, its assignees, and transferees to copyright, use, and publish the same in print and/or electronically. I agree that WTCS may use such photographs of my child with or without my name and for any lawful purpose, including but not limited to publicity, illustration, advertising, and web content. Yes No Photography Permission (only within WTCS): I grant WTCS the right to take photographs of my child. I authorize WTCS, its assignees, and transferees to print and use these photographs ONLY within the WTCS facility. Photographs of my child may NOT be used for public access use such as publicity, advertising, or web content. Yes No Legal AGREEMENT The undersigned hereby does release and discharge Williston Trinity Christian School (WTCS), its employees, board members and agents from any claims, lawsuits and/or damages whatsoever for any alleged injury to my child. The undersigned also agrees to defend and indemnify Williston Trinity Christian School (WTCS), its employees, board members and agents from any claims and/or lawsuits made by any person or entity on behalf of my child.Father SignatureMother SignatureStatement of Parent SupportAs parent(s) we recognize that we are fully responsible for our child(ren). In placing our child(ren) in Williston Trinity Christian School, we place him/her under the authority of the school and will support the goals and standards of the school. We agree to the following: I will contribute my time and abilities to the school continually, as needed. I will support and uphold the school staff and board in matters of discipline. I will encourage my child in positive attitudes toward the school by my own conversation and attitude. I will cooperate in training my child to respect school property and pay for any abuse or damages. I will attend parent functions, if at all possible. I will contact the school concerning any problem or grievance. I will not discuss a school problem with friends or other parents until it has been dealt with through the proper channels (i.e., discussing it with the teacher, administrator or board member, as appropriate). I will make prompt tuition payments and notify the business manager if a problem arises. I will give immediate attention to any academic concerns expressed by the staff. We hereby certify that the information submitted in this application is both true and accurate. We have read and agree to abide by the above Parent Commitment and the guidelines in the student handbook, including the school’s Statement of Faith or Statement of Parent Support . As parents we specifically agree to: (MUST be signed by both) 1) Pay full tuition and fees as agreed upon by the parent and the school. 2) Participate in the school’s three fundraising events. 3) Serve the required volunteer hours. 4) Support the school’s cell phone/iPod/iPad (and all other electronic devices) policy. 5) Support the school’s dress code policy. 6) Hold our child(ren) accountable for promptness when arriving at school in the morning and passing from class to class throughout the day. 7) Provision of a laptop and secured internet access for students with usage only in approved school settings and during appropriate class periods. 8) Hold our child(ren) accountable for turning in homework assignments and projects on time, understanding penalties will be enforced when this is violated. Father (or Guardian) SignatureDateMother (or Guardian) SignatureDateTO BE FILLED OUT BY STUDENTS IN GRADES 6-12.Please briefly share about your faith journey and worldview:Student Commitment At Williston Trinity Christian School, we believe that there is right and wrong. We believe that there are moral obligations that have their origins in God. We believe that what we say and do affects those around us. We recognize that the Bible teaches principles of behavior and the importance of self-control (Colossians 3:5-8).As a student at Williston Trinity Christian School, with God’s help, I agree to: 1. Keep my cell phone/iPod and all other electronic devices TURNED OFF and in my locker during designated hours. 2. Follow dress code policy. 2. Be honest at all times and not deceitful. 3. Respect the property of others and not misuse or steal it. 4. Respect and preserve the emotional and sexual integrity of myself and others. 5. Preserve personal purity. 6. Respect and respond properly to authority through spirit, tone of voice, facial expression, and content of my speech. 7. Approach the school and its program with a positive Christian attitude in action, word, and appearance. 8. Approach all social media websites and posts with strong Christian accountability. 9. I will refrain from bullying others in any form. I certify that I have read and will abide by the above Student Commitment, whether at school, home, or elsewhere. I will respect and abide by the guidelines and rules as outlined in the Williston Trinity Christian School handbook, or be subject to disciplinary measures.Student SignatureDate Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
