New student registration for the 2018-19 school year begins February 5th.

After completing the form below you will be prompted to pay the registration fee of $80/ student.
Date *
Student Name *
Student Name
As of September 1, 2018
Date of Birth *
Date of Birth
If different from Street Address
Home Phone *
Home Phone
Father's Name *
Father's Name
Cell Number *
Cell Number
Work Number *
Work Number
Mother's Name *
Mother's Name
Cell Number *
Cell Number
Work Number *
Work Number
Medical Information
Emergency Contact Information
Responsible adult to contact if parents cannot be reached:
Name *
Phone Number *
Phone Number
Physician's Phone Number *
Physician's Phone Number
List up to six people
Statement of Cooperation *
By typing your name you are agreeing to the Statement of Cooperation above.
Registration Check List
Please provide the school with the following documents
Parent Release Form for Media Recording 2016-2017
as marked by my selection(s) below. Such use includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of my child for use in materials that include, but may not be limited to, printed materials such as brochures and newsletters, newspapers, videos, and digital images such as those on the Jackson Trail Christian School Web site. *
Please type your name
Date *