Student Information - Nareg Armenian Saturday School

Student Name *

First

Last

Աշակերտի Անուն

Birth Date *//

Street Address *

Address Line 1

Address Line 2

City

State

Zip Code

Email Address *

Home Phone *

Father's Name *

Father's Cell # *

Mother's Name *

Mother's Cell # *

Grade in Public School *

Grade in Armenian School *

First Emergency Contact Information - Name *

Relationship *

Mobile # *

Home # *

Second Emergency Contact Information - Name *

Relationship *

Mobile # *

Home # *

Please Check One (when school is physically in session) *

I would like my child/children to walk to the car
I would like to pick up my child/children from the classroom

CONSENT FORM

Nareg Armenian School conducts many activities that are academically challenging and socially entertaining to students. To memorialize these events, we will take pictures of our students as they participate and enjoy these programs.

I, (please add your name in the box below) *

give my permission to use my child’s/children’s (please add the name(s) of your child/children in the box below) *

likeness, image, voice, and/or appearance as such may be embodied in any pictures, photos, video recordings, audiotapes, digital images, and the like, taken or made on behalf of the Nareg Armenian School. I agree that Nareg Armenian School has complete ownership of such pictures and may use them for any purpose consistent with their mission. These uses include, but are not limited to illustrations, bulletin boards, exhibitions, videotapes, reprints, reproductions, publications, advertisements, and any promotional or educational materials in any medium now known or later developed, including the Internet. The photos posted on our Nareg Armenian School Facebook page will only be visible to friends of the group and no one else. I have read and understood this consent and release.

I GIVE my consent
I DO NOT GIVE my consent

to Nareg Armenian School to use my child’s/children’s name and likeness to promote Nareg Armenian School’s activities.

Date / Time *

ALLERGY FORM

To ensure the safety of your child at Nareg Armenian School, the administration is requesting that you complete the following Allergy Form.

Student Name *

Grade *

Parent/Guardian Name *

Phone # *

Mobile # *

Please check the appropriate box: (Allergy can be related to food, drug, plant, environmental condition, animal, substance, other)

NO Allergies
YES, my child HAS Allergies

If "YES", then kindly specify type and additional comments in the box below

Immunization

By clicking this box I confirm, that I will email my children's immunization papers to info@naregarmenianschool.com

Confirmation

By clicking this box I hereby confirm, under legal obligation, that all the information I provided is true to the best of my knowledge.

Date *