We are currently accepting applications for the 2021-22 school year. Please fill out ALL required fields of this form. If you have any questions or concerns you'd like to discuss with us, please call 704 366 3984 or email [email protected]Please Note: Ohr HaTorah membership is recommended for families participating in the CKids program. For more info about membership call Brenda at 704 366 3984.We look forward to a wonderful year of learning and growth! Please submit your CKids payment , then return to this form to complete your registrationReturning StudentsStudent 1Full Name*First NameLast NameGrade*Which CKids will you be joining?CKids in PersonCKids VirtualStudent 2Full NameFirst NameLast NameGradeWhich CKids will you be joining?CKids in PersonCKids VirtualStudent 3Full NameFirst NameLast NameGradeWhich CKids will you be joining?CKids in PersonCKids VirtualNew StudentFull NameFirst NameLast NameHebrew NameBirth Date1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - DecemberMonth12345678910111213141516171819202122232425262728293031Day202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920YearSchoolGradeKindergarten1st2nd3rd4th5th6thUpdate Family & Contact InformationPlease fill in only if changes have been made since last yearMotherPhone NumberArea CodePhone NumberE-mailFatherPhone NumberArea CodePhone NumberE-mailHouseholdPlease fill in only if changes have been made since last yearChange of AddressStreet AddressStreet Address Line 2CityState / ProvincePostal / Zip CodePlease SelectUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanThe BahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChilePeople's Republic of ChinaRepublic of ChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonThe GambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern MarianaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint BarthelemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSomalilandSouth AfricaSouth OssetiaSpainSri LankaSudanSurinameSvalbardSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTristan da CunhaTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamBritish Virgin IslandsUS Virgin IslandsWallis and FutunaWestern SaharaYemenZambiaZimbabweOtherCountryChange of Parents marital statusMarriedDivorcedSeparatedIf separated or divorced, please respond to the following questions: With whom does the child(ren) reside? To whom shall school correspondence be sent?Emergency Medical Information (required)Emergency Contact #1*First NameLast NamePhone Contact #1*Area CodePhone NumberEmergency Contact #2*First NameLast NamePhone Contact #2*Area CodePhone Number1. Is your child/children allergic to any foods? If yes, please explain in detail2. Is there any special medical or any other information regarding your child/children that our school should be aware of?TermsAs the parent(s) or legal guardian(s) of child/ren noted above, I/we authorize any adult acting on behalf of CKids to hospitalize or secure treatment for my child. I further agree to pay for all charges for that care and/or treatment. It is understood that, if time and circumstances reasonably permit, the staff will try to communicate with me prior to such treatment.I/we hereby give permission for my child/ren to attend all field trips and outings organized by CKids. I/we hereby give permission for my child/ren to be transported by CKids on field trips. I/we allow my child/ren to be photographed while participating during school activities. I/we understand that these photographs may be used for publicity purposes. I accept the terms above*AcceptGuardian Digital Signature*First NameLast NameSubmitShould be Empty: This page uses TLS encryption to keep your data secure.