This is for NEW family registration only
Current families, please register through JMC
This must be filled out for each student in a family
Student - General Information
Student Name (F,L): Gender: Male Female
Date of Birth: City/State of Birth:
Religion: Baptism Date: SSN (Optional):
Baptismal Church / City:
Primary Language: Ethnicity:
Grade Student is going into: Preschool Kindergarten 1st Grade 2nd Grade
3rd Grade 4th Grade 5th Grade 6th Grade
Student - Health Information
Are there any health concerns we should be aware of for this child: If so, please let us know what they are:
Will your child be receiving prescription medications during the school day: Yes No
If you answered yes above, please list the prescription medications that your child will receive during school hours:
May your child receive OTC meds such as Tylenol (Acetaminophen) / Advil (Ibuprofen) at school: Yes No
May your child receive OTC cough drops at school: Yes No
Student - Permissions
Photo Permission: I give Danbury Catholic School (DCS) permission to use my child's picture or likeness in publications that are directly related to the publicity of DCS as it pertains to the school / educational activities of my child. Yes No
Technology/Internet Permission: I give my child permission to use Technology / Internet in a supervised setting as it pertains to the school / educational activities used in the classroom. Yes No
Field Trip Permission: I give Danbury Catholic School (DCS) and the volunteers who represent DCS permission to transport my child on an educational field-trip during the school year. Yes No
(It is understood that information for such trips will be sent home by the teacher or school for further notification.)
Social Media Permission: I give Danbury Catholic School (DCS) permission to use my child's picture, likeness or voice (videos posted) in social media posts that are directly related to the publicity of DCS as it pertains to the school / educational activities of my child. Yes No
Radio Advertising Permission: I give Danbury Catholic School (DCS) permission to use my child's voice in in radio advertisements that are directly related to the publicity of DCS as it pertains to the school / educational activities of my child. Yes No
All School Directory Permission: I wish to have my name, my spouse's name, my child’s name, address, phone number and e-mail address published in the DAS All School Directory. Yes No
(This directory is published for Danbury Catholic School staff and student famililes only.)
Family - General Information
Father's Information Mother's Information
Father/Step-Father/Guardian Name (F,L) Mother/Step-Mother/Guardian Name (F,L)
Father's Cell Father's Work Number Mother's Cell Mother's Work Number
Father's Work Place Mother's Work Place
Father's E-mail Mother's E-Mail
Address:
Home Phone:
How did you find out about Danbury Catholic School?:
Family - Medical Contacts
Family Physician: Phone Number:
Family Eye Doctor: Phone Number:
Family Dentist: Phone Number:
Hospital/Clinic Preference: Phone Number:
Insurance Company: Policy Number:
Family - Transportation Contacts
My child will get to school and back home by:
Please List the Name & Phone Number of those people that have your permission to pick-up your child without contacting you beforehand or without you calling the school in advance.
Contact 1 Name (F,L): Phone Number:
Contact 2 Name (F,L): Phone Number:
Contact 3 Name (F,L): Phone Number:
Contact 4 Name (F,L): Phone Number:
Contact 5 Name (F,L): Phone Number:
Contact 6 Name (F,L): Phone Number:
Family - Service Possibilities
As Catholic’s and Christians it is our belief that being of service to those around us is an important part of who we are. Here at Danbury Catholic, we believe in service to our Church, our Community and our Family. With that being said, we have put together a list of possible service areas that occur during the school year at Danbury Catholic (our school community and our school family). It is our request that each family sign-up for a minimum of two (2) service possibilities sometime throughout the school year. Thank you for continuing to be the primary role model and educator of your student. We appreciate all you do to assist us.
Service Possibities at Danbury Catholic:
You may find Danbury Catholic School Brochures and Supply Lists on our school website at www.danburycatholic.org.
Should you have any further questions, please call the school at 712-883-2244. Messages will be returned as soon as possible.
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