Application for Admissions

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Student Health Information

Parents: If your child is rushed to the ER room for medical treatment, the ER physician will be asking the school some of the following questions concerning your child’s health. Please take a few moments to complete the questions below.

Emergency Hospital Information

Students will be taken to Garden City Hospital located on Inkster Rd. For ER care. A staff or faculty member will accompany and remain with the student until a parent/guardian arrives.

Emergency Contact/Authorized Pick-Up Persons

The school has permission to contact the following adults for medical emergencies such as ER treatment, field trip permission or to pick up my child(ren) during or after school when I cannot be contacted.


By signing below, that as the parent/guardian of my child, this application is accurate to the best of my ability. The name listed for emergency contact is the only individuals to whom my child will be released. If I need to add additional name to the list, I will communicate with the school to add additional names to the list. Please remember to submit a copy of immunization records, diagnostic report if applicable, and previous school records if applicable.