Date of Last Upload:
Thursday, October 10, 2024
Student Enrollment Form
New Student Information
Select the Submit Application tab after you have filled in all information including students, primary and secondary family, and emergency/contacts. Use the tab buttons to select the pages to fill in the information.
*
Required fields are bold.
Student's Information
Primary Family Information
Secondary Family Information
Contact Information
Submit Application
Student 1
*
Last Name
*
First Name
Middle Name
Preferred Name
Suffix
<None>
Jr
Sr
II
III
IV
SC
V
*
Date of Birth (mm/dd/yyyy)
Student E-Mail (if applicable)
Student Cell Phone (if applicable)
Primary Contact Phone
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
More Than 1 Race
Native American
Blood Type
<None>
A+
A-
AB+
AB-
B+
B-
O+
O-
Attends Church
<None>
Never
On Occasion
Regular
Church Affiliation
<None>
*GSBC
Assembly of God
Baptist
Catholic
Church of God
Episcopal
Methodist
Mormon
Nazaree
Non-Denominational
None
Other
Pentacostal
Presbyterian
Profession of Faith
Baptized
Immunization Card Expiration Date
Allergies
Medical Conditions
Medications
Media Release
<None>
<None>
No
Yes
TShirt Size
<None>
L
M
S
XL
XXL
YL
YM
YS
YXL
YXS
*** DAYCARE / SCHOOL REGISTRATION ***
*** SUMMER CAMP REGISTRATION ***
Registering For:
<None>
<None>
CDC
SCH
NEW students registering for SUMMER CAMP ONLY, check this box.
Summer Camp ONLY
CDC = Daycare / SCH = School
*
Grade Level Registering For:
<None>
Infants
PK1
PK2
PK3
PK4
PK4-B
K5
1
2
3
4
5
6
7
8
9
10
11
12
SUMMER CAMP
NEW students who would like to ADD Summer Camp to their SCHOOL registration or CURRENTLY ENROLLED GSCS students who like to ADD Summer Camp to their enrollment, check this box.
If you are applying for Summer Camp ONLY, select Grade Level "Summer Camp".
*CURRENT GSCS Students only need to provide required information for this enrollment form.
ADD Summer Camp
Please select the correct Summer Camp age group for the student based on grade COMPLETED.
Summer Camp GROUP:
<None>
1st-2nd
3rd-5th
K4-K5
Student 2
*
Last Name
*
First Name
Middle Name
Preferred Name
Suffix
<None>
Jr
Sr
II
III
IV
SC
V
*
Date of Birth (mm/dd/yyyy)
Student E-Mail (if applicable)
Student Cell Phone (if applicable)
Primary Contact Phone
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
More Than 1 Race
Native American
Blood Type
<None>
A+
A-
AB+
AB-
B+
B-
O+
O-
Attends Church
<None>
Never
On Occasion
Regular
Church Affiliation
<None>
*GSBC
Assembly of God
Baptist
Catholic
Church of God
Episcopal
Methodist
Mormon
Nazaree
Non-Denominational
None
Other
Pentacostal
Presbyterian
Profession of Faith
Baptized
Immunization Card Expiration Date
Allergies
Medical Conditions
Medications
Media Release
<None>
<None>
No
Yes
TShirt Size
<None>
L
M
S
XL
XXL
YL
YM
YS
YXL
YXS
*** DAYCARE / SCHOOL REGISTRATION ***
*** SUMMER CAMP REGISTRATION ***
Registering For:
<None>
<None>
CDC
SCH
NEW students registering for SUMMER CAMP ONLY, check this box.
Summer Camp ONLY
CDC = Daycare / SCH = School
*
Grade Level Registering For:
<None>
Infants
PK1
PK2
PK3
PK4
PK4-B
K5
1
2
3
4
5
6
7
8
9
10
11
12
SUMMER CAMP
NEW students who would like to ADD Summer Camp to their SCHOOL registration or CURRENTLY ENROLLED GSCS students who like to ADD Summer Camp to their enrollment, check this box.
If you are applying for Summer Camp ONLY, select Grade Level "Summer Camp".
*CURRENT GSCS Students only need to provide required information for this enrollment form.
ADD Summer Camp
Please select the correct Summer Camp age group for the student based on grade COMPLETED.
Summer Camp GROUP:
<None>
1st-2nd
3rd-5th
K4-K5
Student 3
*
Last Name
*
First Name
Middle Name
Preferred Name
Suffix
<None>
Jr
Sr
II
III
IV
SC
V
*
Date of Birth (mm/dd/yyyy)
Student E-Mail (if applicable)
Student Cell Phone (if applicable)
Primary Contact Phone
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
More Than 1 Race
Native American
Blood Type
<None>
A+
A-
AB+
AB-
B+
B-
O+
O-
Attends Church
<None>
Never
On Occasion
Regular
Church Affiliation
<None>
*GSBC
Assembly of God
Baptist
Catholic
Church of God
Episcopal
Methodist
Mormon
Nazaree
Non-Denominational
None
Other
Pentacostal
Presbyterian
Profession of Faith
Baptized
Immunization Card Expiration Date
Allergies
Medical Conditions
Medications
Media Release
<None>
<None>
No
Yes
TShirt Size
<None>
L
M
S
XL
XXL
YL
YM
YS
YXL
YXS
*** DAYCARE / SCHOOL REGISTRATION ***
*** SUMMER CAMP REGISTRATION ***
Registering For:
<None>
<None>
CDC
SCH
NEW students registering for SUMMER CAMP ONLY, check this box.
Summer Camp ONLY
CDC = Daycare / SCH = School
*
Grade Level Registering For:
<None>
Infants
PK1
PK2
PK3
PK4
PK4-B
K5
1
2
3
4
5
6
7
8
9
10
11
12
SUMMER CAMP
NEW students who would like to ADD Summer Camp to their SCHOOL registration or CURRENTLY ENROLLED GSCS students who like to ADD Summer Camp to their enrollment, check this box.
If you are applying for Summer Camp ONLY, select Grade Level "Summer Camp".
*CURRENT GSCS Students only need to provide required information for this enrollment form.
ADD Summer Camp
Please select the correct Summer Camp age group for the student based on grade COMPLETED.
Summer Camp GROUP:
<None>
1st-2nd
3rd-5th
K4-K5
Student 4
*
Last Name
*
First Name
Middle Name
Preferred Name
Suffix
<None>
Jr
Sr
II
III
IV
SC
V
*
Date of Birth (mm/dd/yyyy)
Student E-Mail (if applicable)
Student Cell Phone (if applicable)
Primary Contact Phone
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
More Than 1 Race
Native American
Blood Type
<None>
A+
A-
AB+
AB-
B+
B-
O+
O-
Attends Church
<None>
Never
On Occasion
Regular
Church Affiliation
<None>
*GSBC
Assembly of God
Baptist
Catholic
Church of God
Episcopal
Methodist
Mormon
Nazaree
Non-Denominational
None
Other
Pentacostal
Presbyterian
Profession of Faith
Baptized
Immunization Card Expiration Date
Allergies
Medical Conditions
Medications
Media Release
<None>
<None>
No
Yes
TShirt Size
<None>
L
M
S
XL
XXL
YL
YM
YS
YXL
YXS
*** DAYCARE / SCHOOL REGISTRATION ***
*** SUMMER CAMP REGISTRATION ***
Registering For:
<None>
<None>
CDC
SCH
NEW students registering for SUMMER CAMP ONLY, check this box.
Summer Camp ONLY
CDC = Daycare / SCH = School
*
Grade Level Registering For:
<None>
Infants
PK1
PK2
PK3
PK4
PK4-B
K5
1
2
3
4
5
6
7
8
9
10
11
12
SUMMER CAMP
NEW students who would like to ADD Summer Camp to their SCHOOL registration or CURRENTLY ENROLLED GSCS students who like to ADD Summer Camp to their enrollment, check this box.
If you are applying for Summer Camp ONLY, select Grade Level "Summer Camp".
*CURRENT GSCS Students only need to provide required information for this enrollment form.
ADD Summer Camp
Please select the correct Summer Camp age group for the student based on grade COMPLETED.
Summer Camp GROUP:
<None>
1st-2nd
3rd-5th
K4-K5
Student 5
*
Last Name
*
First Name
Middle Name
Preferred Name
Suffix
<None>
Jr
Sr
II
III
IV
SC
V
*
Date of Birth (mm/dd/yyyy)
Student E-Mail (if applicable)
Student Cell Phone (if applicable)
Primary Contact Phone
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
More Than 1 Race
Native American
Blood Type
<None>
A+
A-
AB+
AB-
B+
B-
O+
O-
Attends Church
<None>
Never
On Occasion
Regular
Church Affiliation
<None>
*GSBC
Assembly of God
Baptist
Catholic
Church of God
Episcopal
Methodist
Mormon
Nazaree
Non-Denominational
None
Other
Pentacostal
Presbyterian
Profession of Faith
Baptized
Immunization Card Expiration Date
Allergies
Medical Conditions
Medications
Media Release
<None>
<None>
No
Yes
TShirt Size
<None>
L
M
S
XL
XXL
YL
YM
YS
YXL
YXS
*** DAYCARE / SCHOOL REGISTRATION ***
*** SUMMER CAMP REGISTRATION ***
Registering For:
<None>
<None>
CDC
SCH
NEW students registering for SUMMER CAMP ONLY, check this box.
Summer Camp ONLY
CDC = Daycare / SCH = School
*
Grade Level Registering For:
<None>
Infants
PK1
PK2
PK3
PK4
PK4-B
K5
1
2
3
4
5
6
7
8
9
10
11
12
SUMMER CAMP
NEW students who would like to ADD Summer Camp to their SCHOOL registration or CURRENTLY ENROLLED GSCS students who like to ADD Summer Camp to their enrollment, check this box.
If you are applying for Summer Camp ONLY, select Grade Level "Summer Camp".
*CURRENT GSCS Students only need to provide required information for this enrollment form.
ADD Summer Camp
Please select the correct Summer Camp age group for the student based on grade COMPLETED.
Summer Camp GROUP:
<None>
1st-2nd
3rd-5th
K4-K5
Primary Family Information
*
Address Line 1
Address Line 2
*
City
*
State
*
ZIP Code
Home Phone
Cell Phone
*
Primary Phone Number
Parent 1 Information
*
Last Name
*
First Name
Middle Name
Preferred Name
Date of Birth
Marital Status
<None>
Divorced
Engaged
Married
Separated
Single
Widow
Widower
Suffix
<None>
Jr
Sr
II
III
IV
SC
V
Title
<None>
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
SC
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
More Than 1 Race
Native American
*
Primary Contact E-mail
Home Phone
Cell Phone
*
Primary Phone Number
Company Name
Work Phone
Extension
Job Title
Is Emergency Contact
DL State
Business E-Mail
Is Allowed to Pickup
DL Number
DL Exp Date (mm/dd/yyyy)
Parent 2 Information
*
Last Name
*
First Name
Middle Name
Preferred Name
Date of Birth
Marital Status
<None>
Divorced
Engaged
Married
Separated
Single
Widow
Widower
Suffix
<None>
Jr
Sr
II
III
IV
SC
V
Title
<None>
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
SC
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
More Than 1 Race
Native American
*
Primary Contact E-mail
Home Phone
Cell Phone
*
Primary Phone Number
Company Name
Work Phone
Extension
Job Title
Is Emergency Contact
DL State
Business E-Mail
Is Allowed to Pickup
DL Number
DL Exp Date (mm/dd/yyyy)
Secondary Family Information
*
Address Line 1
Address Line 2
*
City
*
State
*
ZIP Code
Home Phone
Cell Phone
*
Primary Phone Number
Parent 3 Information
*
Last Name
*
First Name
Middle Name
Preferred Name
Date of Birth
Marital Status
<None>
Divorced
Engaged
Married
Separated
Single
Widow
Widower
Suffix
<None>
Jr
Sr
II
III
IV
SC
V
Title
<None>
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
SC
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
More Than 1 Race
Native American
*
Primary Contact E-mail
Home Phone
Cell Phone
*
Primary Phone Number
Company Name
Work Phone
Extension
Job Title
Is Emergency Contact
DL State
Business E-Mail
Is Allowed to Pickup
DL Number
DL Exp Date (mm/dd/yyyy)
Parent 4 Information
*
Last Name
*
First Name
Middle Name
Preferred Name
Date of Birth
Marital Status
<None>
Divorced
Engaged
Married
Separated
Single
Widow
Widower
Suffix
<None>
Jr
Sr
II
III
IV
SC
V
Title
<None>
Dr.
Miss
Mr.
Mrs.
Ms.
Rev.
SC
Gender
<None>
Female
Male
Race
<None>
African American
Asian
Caucasian
Hispanic
More Than 1 Race
Native American
*
Primary Contact E-mail
Home Phone
Cell Phone
*
Primary Phone Number
Company Name
Work Phone
Extension
Job Title
Is Emergency Contact
DL State
Business E-Mail
Is Allowed to Pickup
DL Number
DL Exp Date (mm/dd/yyyy)
Contact Information (Other than parents)
Contact 1
*
Last Name
*
First Name
Relation
<None>
Aunt
Brother
Father
Mother
Uncle
Sister
Grandmother
Grandfather
Unknown
Family Friend
Other Relative
Guardian
Stepfather
Stepmother
Neighbor
Foster Parent
Spouse
Daughter
GodParents
Babby sitter
Babysitter
Godsister
Son
Pastor
Niece
grandchild
Husband
Mother-in-law
Great grandfather
Social Worker
Is Emergency Contact
*
Primary Phone Number
Is Allowed to Pickup
Business Phone
Pickup License
Mobile Phone
Pickup Tag
Pickup Notes
Contact 2
*
Last Name
*
First Name
Relation
<None>
Aunt
Brother
Father
Mother
Uncle
Sister
Grandmother
Grandfather
Unknown
Family Friend
Other Relative
Guardian
Stepfather
Stepmother
Neighbor
Foster Parent
Spouse
Daughter
GodParents
Babby sitter
Babysitter
Godsister
Son
Pastor
Niece
grandchild
Husband
Mother-in-law
Great grandfather
Social Worker
Is Emergency Contact
*
Primary Phone Number
Is Allowed to Pickup
Business Phone
Pickup License
Mobile Phone
Pickup Tag
Pickup Notes
Contact 3
*
Last Name
*
First Name
Relation
<None>
Aunt
Brother
Father
Mother
Uncle
Sister
Grandmother
Grandfather
Unknown
Family Friend
Other Relative
Guardian
Stepfather
Stepmother
Neighbor
Foster Parent
Spouse
Daughter
GodParents
Babby sitter
Babysitter
Godsister
Son
Pastor
Niece
grandchild
Husband
Mother-in-law
Great grandfather
Social Worker
Is Emergency Contact
*
Primary Phone Number
Is Allowed to Pickup
Business Phone
Pickup License
Mobile Phone
Pickup Tag
Pickup Notes
Medical Contacts
Physician
Physician Phone Number
Dentist
Dentist Phone Number
Hospital
Hospital Phone Number
Insurance
Insurance Phone Number
Policy Number
Finished
Confirmation E-Mail address:
Please press the save button to submit the new student application.
