{"id":8428,"date":"2026-04-20T14:10:14","date_gmt":"2026-04-20T14:10:14","guid":{"rendered":"https:\/\/fraysercs.org\/staging\/5603\/?page_id=8428"},"modified":"2026-06-10T18:05:55","modified_gmt":"2026-06-10T18:05:55","slug":"registration","status":"publish","type":"page","link":"https:\/\/fraysercs.org\/staging\/5603\/registration\/","title":{"rendered":"Registration"},"content":{"rendered":"<div class=\"wpb-content-wrapper\"><p>[vc_row css_animation=&#8221;fadeIn&#8221;][vc_column]<div class=\"conceptseven-headings clearfix  wow fadeInRight\"  data-wow-duration=\"0.75s\" data-wow-delay=\"0.3s\" style=\"\"><h3 class=\"heading clearfix \" style=\"color:#A20000;\">\r\n\t\t2026-2027 Academic Year\r\n\t<\/h3><\/div>\r\n\t<div class=\"conceptseven-spacer clearfix\" data-desktop=\"32\" data-mobi=\"32\" data-smobi=\"32\"><\/div><div class=\"conceptseven-headings clearfix  wow fadeInLeft\"  data-wow-duration=\"0.75s\" data-wow-delay=\"0.3s\" style=\"\"><h3 class=\"heading clearfix \" style=\"margin-bottom:32px;\">\r\n\t\tStart your Child's Journey at Westside Middle School\r\n\t<\/h3><p class=\"sub-heading clearfix\" style=\"font-style:normal;\">\r\n\t\tChoosing the right middle school is one of the most important decisions you can make for your child\u2019s future, and Westside Middle School stands out as the premier choice in West Tennessee.\r\n\t<\/p><\/div>\r\n\t<div class=\"conceptseven-spacer clearfix\" data-desktop=\"32\" data-mobi=\"32\" data-smobi=\"32\"><\/div>[vc_column_text css_animation=&#8221;fadeInLeft&#8221; css=&#8221;&#8221;]<\/p>\n<p data-start=\"58\" data-end=\"437\">With a commitment to academic excellence, supportive teachers, and a thriving student community, Westside provides an environment where students don\u2019t just learn, they grow, lead, and succeed. At Westside, students are encouraged to explore their interests, build confidence, and develop the skills they need for high school and beyond. From engaging classroom experiences to extracurricular opportunities, every aspect of the school is designed to help your child reach their full potential.<\/p>\n<p data-start=\"740\" data-end=\"1032\">Registering is simple, and it\u2019s the first step toward unlocking these opportunities. By completing the registration below, you\u2019re not just enrolling your child in a school, you\u2019re investing in their future, surrounding them with educators who care, and placing them on a clear path to success.<\/p>\n<p data-start=\"1034\" data-end=\"1092\" data-is-last-node=\"\" data-is-only-node=\"\">Take the next step today. Your child\u2019s future starts here.<\/p>\n<p>[\/vc_column_text]\r\n\t<div class=\"conceptseven-spacer clearfix\" data-desktop=\"32\" data-mobi=\"32\" data-smobi=\"32\"><\/div><div class=\"conceptseven-headings clearfix  wow fadeInRight\"  data-wow-duration=\"0.75s\" data-wow-delay=\"0.3s\" style=\"\"><h3 class=\"heading clearfix \" style=\"\">\r\n\t\tRegistration Form\r\n\t<\/h3><\/div>\r\n\t<div class=\"conceptseven-spacer clearfix\" data-desktop=\"32\" data-mobi=\"32\" data-smobi=\"32\"><\/div>[vc_column_text css_animation=&#8221;fadeIn&#8221; css=&#8221;.vc_custom_1781114731452{padding-top: 32px !important;padding-right: 32px !important;padding-bottom: 32px !important;padding-left: 32px !important;background-color: #E6E6E6 !important;}&#8221;]<div class='fluentform ff-default fluentform_wrapper_3 ffs_default_wrap'><form data-form_id=\"3\" id=\"fluentform_3\" class=\"frm-fluent-form fluent_form_3 ff-el-form-top ff_form_instance_3_1 ff-form-loading ffs_default\" data-form_instance=\"ff_form_instance_3_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">Westside Middle School Registration Form<\/legend><input type='hidden' name='__fluent_form_embded_post_id' value='8428' \/><input type=\"hidden\" id=\"_fluentform_3_fluentformnonce\" name=\"_fluentform_3_fluentformnonce\" value=\"1c9ecabd4a\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/staging\/5603\/wp-json\/wp\/v2\/pages\/8428\" \/><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-3_1\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><p><strong>Student Information<\/strong><\/p>\n<p>Please complete the following:<\/p><\/div><hr \/><\/div><div data-type=\"name-element\" data-name=\"names\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_first_name_' id='label_ff_3_names_first_name_' >First Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[first_name]\" id=\"ff_3_names_first_name_\" class=\"ff-el-form-control\" placeholder=\"Enter Your First Name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_last_name_' id='label_ff_3_names_last_name_' >Last Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names[last_name]\" id=\"ff_3_names_last_name_\" class=\"ff-el-form-control\" placeholder=\"Enter Your Last Name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_1\"  class='ff-t-container ff-column-container ff_columns_total_2 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_datetime' id='label_ff_3_datetime' aria-label=\"Date of Birth\">Date of Birth<\/label><\/div><div class='ff-el-input--content'><input  aria-label='Date of Birth Use arrow keys to navigate dates. Press enter to select a date.'  aria-haspopup='dialog' data-type-datepicker data-format='d\/m\/Y' type=\"text\" name=\"datetime\" id=\"ff_3_datetime\" class=\"ff-el-form-control ff-el-datepicker\" data-name=\"datetime\"  aria-invalid='false' aria-required=true><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_input_text' id='label_ff_3_input_text' aria-label=\"Age\">Age<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text\" class=\"ff-el-form-control\" data-name=\"input_text\" id=\"ff_3_input_text\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_2\"  class='ff-t-container ff-column-container ff_columns_total_2 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_dropdown' id='label_ff_3_dropdown' aria-label=\"Race\/Ethnicity\">Race\/Ethnicity<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown\" id=\"ff_3_dropdown\" class=\"ff-el-form-control\" data-name=\"dropdown\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_3_dropdown\"><option value=\"\">- Select -<\/option><option value=\"African American\"  >African American<\/option><option value=\"White\"  >White<\/option><option value=\"Hispanic\"  >Hispanic<\/option><option value=\"American Indian\"  >American Indian<\/option><option value=\"Other\/Multiple Races\"  >Other\/Multiple Races<\/option><\/select><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_dropdown_1' id='label_ff_3_dropdown_1' aria-label=\"Student Grade\">Student Grade<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_1\" id=\"ff_3_dropdown_1\" class=\"ff-el-form-control\" data-name=\"dropdown_1\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_3_dropdown_1\"><option value=\"\">- Select -<\/option><option value=\"6\"  >6<\/option><option value=\"7\"  >7<\/option><option value=\"8\"  >8<\/option><\/select><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_3\"  class='ff-t-container ff-column-container ff_columns_total_1 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 100%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_input_text_1' id='label_ff_3_input_text_1' aria-label=\"Name of Previously Attended School\">Name of Previously Attended School<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_1\" class=\"ff-el-form-control\" data-name=\"input_text_1\" id=\"ff_3_input_text_1\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_dropdown_2' id='label_ff_3_dropdown_2' aria-label=\"Is English the Primary Language Spoken?\">Is English the Primary Language Spoken?<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_2\" id=\"ff_3_dropdown_2\" class=\"ff-el-form-control\" data-name=\"dropdown_2\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_3_dropdown_2\"><option value=\"\">- Select -<\/option><option value=\"Yes\"  >Yes<\/option><option value=\"No\"  >No<\/option><\/select><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_dropdown_3' id='label_ff_3_dropdown_3' aria-label=\"Student Lives With?\">Student Lives With?<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_3\" id=\"ff_3_dropdown_3\" class=\"ff-el-form-control\" data-name=\"dropdown_3\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_3_dropdown_3\"><option value=\"\">- Select -<\/option><option value=\"Mother\"  >Mother<\/option><option value=\"Father\"  >Father<\/option><option value=\"Both Parents\"  >Both Parents<\/option><option value=\"Grandmother\"  >Grandmother<\/option><option value=\"Guardian\"  >Guardian<\/option><\/select><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_dropdown_4' id='label_ff_3_dropdown_4' aria-label=\"Childs method of transportation home from school\">Childs method of transportation home from school<\/label><\/div><div class='ff-el-input--content'><select name=\"dropdown_4\" id=\"ff_3_dropdown_4\" class=\"ff-el-form-control\" data-name=\"dropdown_4\" data-calc_value=\"0\"  aria-invalid=\"false\" aria-required=\"true\" aria-labelledby=\"label_ff_3_dropdown_4\"><option value=\"\">- Select -<\/option><option value=\"Walker\"  >Walker<\/option><option value=\"Car Rider\"  >Car Rider<\/option><option value=\"Bus\"  >Bus<\/option><\/select><\/div><\/div><div data-type=\"name-element\" data-name=\"names_1\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_1_first_name_' id='label_ff_3_names_1_first_name_' >Mother\/Guardian First Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_1[first_name]\" id=\"ff_3_names_1_first_name_\" class=\"ff-el-form-control\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_names_1_last_name_' id='label_ff_3_names_1_last_name_' >Mother\/Guardian Last Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_1[last_name]\" id=\"ff_3_names_1_last_name_\" class=\"ff-el-form-control\" aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><\/div><div class=\"ff-name-address-wrapper fluent-address\" data-type=\"address-element\" data-name=\"address_1\" ><div class='ff-el-input--label'><label aria-label=\"Physical Address\">Physical Address<\/label><\/div><div class='ff-el-input--content'><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_address_1_address_line_1_' id='label_ff_3_address_1_address_line_1_' aria-label=\"Address Line 1\">Address Line 1<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[address_line_1]\" id=\"ff_3_address_1_address_line_1_\" class=\"ff-el-form-control\" data-key_name=\"address_line_1\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_3_address_1_address_line_2_' id='label_ff_3_address_1_address_line_2_' aria-label=\"Address Line 2\">Address Line 2<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[address_line_2]\" id=\"ff_3_address_1_address_line_2_\" class=\"ff-el-form-control\" data-key_name=\"address_line_2\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><\/div><\/div><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_address_1_city_' id='label_ff_3_address_1_city_' aria-label=\"City\">City<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[city]\" id=\"ff_3_address_1_city_\" class=\"ff-el-form-control\" data-key_name=\"city\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_address_1_state_' id='label_ff_3_address_1_state_' aria-label=\"State\">State<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[state]\" id=\"ff_3_address_1_state_\" class=\"ff-el-form-control\" data-key_name=\"state\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><div class='ff-t-container'><div class='ff-t-cell'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_address_1_zip_' id='label_ff_3_address_1_zip_' aria-label=\"Zip Code\">Zip Code<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"address_1[zip]\" id=\"ff_3_address_1_zip_\" class=\"ff-el-form-control\" data-key_name=\"zip\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><\/div><div data-name=\"ff_cn_id_4\"  class='ff-t-container ff-column-container ff_columns_total_2 '><div class='ff-t-cell ff-t-column-1' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_numeric_field' id='label_ff_3_numeric_field' aria-label=\"Home Phone\">Home Phone<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric_field\" id=\"ff_3_numeric_field\" class=\"ff-el-form-control\" data-name=\"numeric_field\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell ff-t-column-2' style='flex-basis: 50%;'><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_numeric_field_1' id='label_ff_3_numeric_field_1' aria-label=\"Cell Phone\">Cell Phone<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric_field_1\" id=\"ff_3_numeric_field_1\" class=\"ff-el-form-control\" data-name=\"numeric_field_1\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_email' id='label_ff_3_email' aria-label=\"Email Address\">Email Address<\/label><\/div><div class='ff-el-input--content'><input type=\"email\" name=\"email\" id=\"ff_3_email\" class=\"ff-el-form-control\" data-name=\"email\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-3_2\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><p><strong>Emergency Contact Information<\/strong><\/p>\n<p>In case of an emergency, contact:<\/p><\/div><hr \/><\/div><div data-type=\"name-element\" data-name=\"names_2\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_2_first_name_' id='label_ff_3_names_2_first_name_' >Emergency Contact #1 First Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_2[first_name]\" id=\"ff_3_names_2_first_name_\" class=\"ff-el-form-control\" placeholder=\"Enter First Name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_2_last_name_' id='label_ff_3_names_2_last_name_' >Emergency Contact #1 Last Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_2[last_name]\" id=\"ff_3_names_2_last_name_\" class=\"ff-el-form-control\" placeholder=\"Enter Last Name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_numeric_field_2' id='label_ff_3_numeric_field_2' aria-label=\"Emergency Contact #1 Phone\">Emergency Contact #1 Phone<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"numeric_field_2\" id=\"ff_3_numeric_field_2\" class=\"ff-el-form-control\" data-name=\"numeric_field_2\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_input_text_3' id='label_ff_3_input_text_3' aria-label=\"Relationship to Student\">Relationship to Student<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_3\" class=\"ff-el-form-control\" data-name=\"input_text_3\" id=\"ff_3_input_text_3\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div data-type=\"name-element\" data-name=\"names_3\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_3_first_name_' id='label_ff_3_names_3_first_name_' >Emergency Contact #2 First Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_3[first_name]\" id=\"ff_3_names_3_first_name_\" class=\"ff-el-form-control\" placeholder=\"Enter First Name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_3_last_name_' id='label_ff_3_names_3_last_name_' >Emergency Contact #2 Last Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_3[last_name]\" id=\"ff_3_names_3_last_name_\" class=\"ff-el-form-control\" placeholder=\"Enter Last Name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_input_text_2' id='label_ff_3_input_text_2' aria-label=\"Relationship to Student\">Relationship to Student<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_2\" class=\"ff-el-form-control\" data-name=\"input_text_2\" id=\"ff_3_input_text_2\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-3_3\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><p><strong>Authorized for Pickup\/Dismissal:<\/strong><\/p>\n<p>Please list the names of ALL persons who are authorized to check out your child from school. If you send an individual whose name is not on this list, he or she Will NOT be given authority to check out your child.\u00a0<\/p><\/div><hr \/><\/div><div data-type=\"name-element\" data-name=\"names_4\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_4_first_name_' id='label_ff_3_names_4_first_name_' >Contact #1 First Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_4[first_name]\" id=\"ff_3_names_4_first_name_\" class=\"ff-el-form-control\" placeholder=\"Enter First Name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_4_last_name_' id='label_ff_3_names_4_last_name_' >Contact #1 Last Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_4[last_name]\" id=\"ff_3_names_4_last_name_\" class=\"ff-el-form-control\" placeholder=\"Enter Last Name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_input_text_4' id='label_ff_3_input_text_4' aria-label=\"Relationship to Student\">Relationship to Student<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_4\" class=\"ff-el-form-control\" data-name=\"input_text_4\" id=\"ff_3_input_text_4\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div data-type=\"name-element\" data-name=\"names_5\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_5_first_name_' id='label_ff_3_names_5_first_name_' >Contact #2 First Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_5[first_name]\" id=\"ff_3_names_5_first_name_\" class=\"ff-el-form-control\" placeholder=\"Enter First Name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_5_last_name_' id='label_ff_3_names_5_last_name_' >Contact #2 Last Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_5[last_name]\" id=\"ff_3_names_5_last_name_\" class=\"ff-el-form-control\" placeholder=\"Enter Last Name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_input_text_5' id='label_ff_3_input_text_5' aria-label=\"Relationship to Student\">Relationship to Student<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_5\" class=\"ff-el-form-control\" data-name=\"input_text_5\" id=\"ff_3_input_text_5\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div data-type=\"name-element\" data-name=\"names_6\" class=\" ff-field_container ff-name-field-wrapper\" ><div class='ff-t-container'><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_6_first_name_' id='label_ff_3_names_6_first_name_' >Contact #3 First Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_6[first_name]\" id=\"ff_3_names_6_first_name_\" class=\"ff-el-form-control\" placeholder=\"Enter First Name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><div class='ff-t-cell '><div class='ff-el-group ff-el-form-top'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_names_6_last_name_' id='label_ff_3_names_6_last_name_' >Contact #3 Last Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"names_6[last_name]\" id=\"ff_3_names_6_last_name_\" class=\"ff-el-form-control\" placeholder=\"Enter Last Name\" aria-invalid=\"false\" aria-required=true><\/div><\/div><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_input_text_6' id='label_ff_3_input_text_6' aria-label=\"Relationship to Student\">Relationship to Student<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_6\" class=\"ff-el-form-control\" data-name=\"input_text_6\" id=\"ff_3_input_text_6\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-3_4\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><p><strong>Student Access Release &amp; Technology Authorization<\/strong><\/p>\n<p>As the parent or legal guardian of the above-named student, I grant permission for him\/her to access networked computer services such as e-mail and the Internet. I understand that he or she is expected to use good judgement and follow rules and guidelines in making contact on the FCS network, including the rules and guidelines set forth in the Acceptable User Agreement.\u00a0 FCS cannot be responsible for the student's use of the FCS network, including any ideas and concepts that he or she may gain y his or her use of the Internet or for the actions he or she takes through the use of the Internet. I release FCS, the School, their officers, agents, and employees from all costs, claims, and liability resulting from the use of the FCS network by the student. I have read the Agreement and accept the rules and conditions in the Agreement.\u00a0 Entering your name below, indicates you grant permission.<\/p>\n<p>&nbsp;<\/p><\/div><hr \/><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_input_text_7' id='label_ff_3_input_text_7' aria-label=\"Your Name\">Your Name<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_7\" class=\"ff-el-form-control\" data-name=\"input_text_7\" id=\"ff_3_input_text_7\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-3_5\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><p><strong>Media Release<\/strong><\/p>\n<p>Throughout the school year, the media may visit your school to cover special events. Frayser Community Schools may also wish to use your child's photograph, likeness, voice, or student work for promotional and educational reasons, such as publications, posters, brochures, and newsletters; on the FCS website, radio station, or cable TV; or at community fairs or other special district events.\u00a0Before your child's photography, likeness, or work can be used by the media or by Frayser Community Schools, you must give your permission.\u00a0 Please sign and indicate your preference. Thank you for your Cooperation.\u00a0<\/p>\n<p>&nbsp;<\/p><\/div><hr \/><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Do you give permission for your child to be filmed\/photographed\/interviewed by the media during the school events and for FCS to use it for promotional and educational purposes.\">Do you give permission for your child to be filmed\/photographed\/interviewed by the media during the school events and for FCS to use it for promotional and educational purposes. <\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_0935c85d773ff8baaa0ad58809d62cec'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"yes\"  id='input_radio_0935c85d773ff8baaa0ad58809d62cec' aria-label='Yes' aria-invalid='false' aria-required=true> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_5e9a45220ddb1f16d0f6f445c69e2dc2'><input  type=\"radio\" name=\"input_radio\" data-name=\"input_radio\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"no\"  id='input_radio_5e9a45220ddb1f16d0f6f445c69e2dc2' aria-label='No' aria-invalid='false' aria-required=true> <span>No<\/span><\/label><\/div><\/div><\/div><div class=\"ff-el-group ff-el-section-break  ff_left\" data-name=\"section_break-3_6\" ><h3 class='ff-el-section-title'><\/h3><div class='ff-section_break_desk'><p><strong>Health\/Medical Information<\/strong><\/p>\n<p>If your child requires medication and\/or medical attention at school, an authorization form must be complete by your physician before medication can be administered by FCS Personnel.\u00a0<\/p>\n<p>&nbsp;<\/p><\/div><hr \/><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_3_input_text_8' id='label_ff_3_input_text_8' aria-label=\"Hospital Preference\">Hospital Preference<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"input_text_8\" class=\"ff-el-form-control\" placeholder=\"Enter Hospital Name Here\" data-name=\"input_text_8\" id=\"ff_3_input_text_8\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Does your student have Health Insurance\">Does your student have Health Insurance<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_9d7c0278232287ea2c0112fdc03f24b0'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"yes\"  id='input_radio_1_9d7c0278232287ea2c0112fdc03f24b0' aria-label='Yes' aria-invalid='false' aria-required=true> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_1_9d00661aaddff07445c1b68f08bc3770'><input  type=\"radio\" name=\"input_radio_1\" data-name=\"input_radio_1\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"no\"  id='input_radio_1_9d00661aaddff07445c1b68f08bc3770' aria-label='No' aria-invalid='false' aria-required=true> <span>No<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff_list_2col'><div class=\"ff-el-input--label asterisk-right\"><label   aria-label=\"Has your child been diagnosed by a physician with any of the following health conditions:\">Has your child been diagnosed by a physician with any of the following health conditions: <\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_9ed26cfb6bc3646b109ba21dc9b48eb4'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"No Health Conditions\"  id='checkbox_9ed26cfb6bc3646b109ba21dc9b48eb4' aria-label='No Health Conditions' aria-invalid='false' aria-required=false> <span>No Health Conditions<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_d4475b2b66c8211bee91b040c4ad6dee'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Diabetes\"  id='checkbox_d4475b2b66c8211bee91b040c4ad6dee' aria-label='Diabetes' aria-invalid='false' aria-required=false> <span>Diabetes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_6c25866fe7b0f6d6d59bb046899603aa'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Asthma\"  id='checkbox_6c25866fe7b0f6d6d59bb046899603aa' aria-label='Asthma' aria-invalid='false' aria-required=false> <span>Asthma<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_c6481d8367d9a36234a8b5d6f047a005'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Sickle Cell\"  id='checkbox_c6481d8367d9a36234a8b5d6f047a005' aria-label='Sickle Cell' aria-invalid='false' aria-required=false> <span>Sickle Cell<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1dea611f62de98e301f1643ff040e1ae'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Heart Problems\"  id='checkbox_1dea611f62de98e301f1643ff040e1ae' aria-label='Heart Problems' aria-invalid='false' aria-required=false> <span>Heart Problems<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_bfee58d27ea2bac711df3b290230bfcd'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"ADHD\/ADD\"  id='checkbox_bfee58d27ea2bac711df3b290230bfcd' aria-label='ADHD\/ADD' aria-invalid='false' aria-required=false> <span>ADHD\/ADD<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_65408fd45ed78df6cc5cb412ea0aee4b'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Seizures\"  id='checkbox_65408fd45ed78df6cc5cb412ea0aee4b' aria-label='Seizures' aria-invalid='false' aria-required=false> <span>Seizures<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_7c10083cdebfdea10cf765f4a607ace2'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Eye Problems\"  id='checkbox_7c10083cdebfdea10cf765f4a607ace2' aria-label='Eye Problems' aria-invalid='false' aria-required=false> <span>Eye Problems<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_b1bc419db99a6b46919e8e8e0b85ba84'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Allergies\"  id='checkbox_b1bc419db99a6b46919e8e8e0b85ba84' aria-label='Allergies' aria-invalid='false' aria-required=false> <span>Allergies<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_4e14be397ecb89eac17daf843ab4c9e6'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Speech Difficulties\"  id='checkbox_4e14be397ecb89eac17daf843ab4c9e6' aria-label='Speech Difficulties' aria-invalid='false' aria-required=false> <span>Speech Difficulties<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_a21a5f1e7a8c3c08742e760b5fa552a5'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Hearing Difficulties\"  id='checkbox_a21a5f1e7a8c3c08742e760b5fa552a5' aria-label='Hearing Difficulties' aria-invalid='false' aria-required=false> <span>Hearing Difficulties<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_c508692ef3e0b48fb3e4b47901cb5e38'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Hearing Problems\"  id='checkbox_c508692ef3e0b48fb3e4b47901cb5e38' aria-label='Hearing Problems' aria-invalid='false' aria-required=false> <span>Hearing Problems<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_83d693a25f6152d7515070610621f469'><input  type=\"checkbox\" name=\"checkbox[]\" data-name=\"checkbox\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Other\"  id='checkbox_83d693a25f6152d7515070610621f469' aria-label='Other' aria-invalid='false' aria-required=false> <span>Other<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Does your child have an EPI Pen?\">Does your child have an EPI Pen?<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_efb98848dd0db1279d60903838ace71c'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"yes\"  id='input_radio_2_efb98848dd0db1279d60903838ace71c' aria-label='Yes' aria-invalid='false' aria-required=true> <span>Yes<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_d356a389bc24d95798978b3eccd0e905'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"no\"  id='input_radio_2_d356a389bc24d95798978b3eccd0e905' aria-label='No' aria-invalid='false' aria-required=true> <span>No<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='input_radio_2_bc7dd92d473dcc257ad4a6f8e2fe6a15'><input  type=\"radio\" name=\"input_radio_2\" data-name=\"input_radio_2\" class=\"ff-el-form-check-input ff-el-form-check-radio\" value=\"Doesn&#039;t Apply\"  id='input_radio_2_bc7dd92d473dcc257ad4a6f8e2fe6a15' aria-label='Doesn&#039;t Apply' aria-invalid='false' aria-required=true> <span>Doesn't Apply<\/span><\/label><\/div><\/div><\/div><div class='ff-el-group ff_list_2col'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label   aria-label=\"Is you child allergic to the following (select all that apply):\">Is you child allergic to the following (select all that apply):<\/label><\/div><div class='ff-el-input--content'><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_e46db3ccd964cc1f608bd517a638b80d'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Nuts\"  id='checkbox_1_e46db3ccd964cc1f608bd517a638b80d' aria-label='Nuts' aria-invalid='false' aria-required=true> <span>Nuts<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_13cb587bcbff071008de2254ad5b368e'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Shellfish\"  id='checkbox_1_13cb587bcbff071008de2254ad5b368e' aria-label='Shellfish' aria-invalid='false' aria-required=true> <span>Shellfish<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_47d364429fefefad16e2affa796ddfc3'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Eggs\/Dairy\"  id='checkbox_1_47d364429fefefad16e2affa796ddfc3' aria-label='Eggs\/Dairy' aria-invalid='false' aria-required=true> <span>Eggs\/Dairy<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_8889dfea559d5725f4dd9217d60f5ff5'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Insects\"  id='checkbox_1_8889dfea559d5725f4dd9217d60f5ff5' aria-label='Insects' aria-invalid='false' aria-required=true> <span>Insects<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_7935c44ae926621d1b95155332c8b15f'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Latex\"  id='checkbox_1_7935c44ae926621d1b95155332c8b15f' aria-label='Latex' aria-invalid='false' aria-required=true> <span>Latex<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_c5d514e17267b6f1b715470fba12d1a2'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Environmental Allergy\"  id='checkbox_1_c5d514e17267b6f1b715470fba12d1a2' aria-label='Environmental Allergy' aria-invalid='false' aria-required=true> <span>Environmental Allergy<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_10ef03a04ce91fd469d110bbebd3158d'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" value=\"Grass\"  id='checkbox_1_10ef03a04ce91fd469d110bbebd3158d' aria-label='Grass' aria-invalid='false' aria-required=true> <span>Grass<\/span><\/label><\/div><div class='ff-el-form-check ff-el-form-check-'><label class='ff-el-form-check-label' for='checkbox_1_c9e54b674fafc88131ce8e4ad1124a35'><input  type=\"checkbox\" name=\"checkbox_1[]\" data-name=\"checkbox_1\" class=\"ff-el-form-check-input ff-el-form-check-checkbox\" 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