Elementary Registration Forms

(Required – each student)Student Information Form
(Existing Mediapolis students may return their pre-printed Student Information Form which was mailed to your primary  address in lieu of filling out this blank form. All new students need to complete this blank form.)

(Required – each student)Parent Permission & Release Form
(The Internet & E-mail Usage, Field Trip Permission, and Student Handbook Acknowledgement are available for review by clicking on this link.)

(Required – each student)Early Dismissal & Severe Weather

(Required – each student)Health Update

(Required – Kindergarten only)Certificate of Dental Screening

(Required – Kindergarten only)Certificate of Immunization

(Required – each new student)Request for Records (new transfer in students only)

(one per family)Elementary School Supply List

(one per family)Fees List

(one per family)Informational Letter Regarding Dates

(one per family)Registration Check-Off List

(one per family)Free & Reduced Meals Application

(one per family)Standard Fee Waiver Application

(one per family)Athletic Pass Order Form

Volunteers & Chaperones (including field trips):
(one per person – annually)Volunteer Acknowledgement Form (All volunteers & chaperones)

(one per person)Background Check: Authorization for Release of Child & Adult Abuse Information Forms

A one- time background check is required on all volunteers and chaperones.
Favorable results are required prior to the school district utilizing your services.