• About Us
    • Our Team
    • Mission and Vision
    • Statement of Faith
  • Admissions
    • Admissions Open House
    • Admissions Process
    • Apply Online
  • Academics
    • Preschool
    • Elementary School
    • Middle School
    • High School
  • School Calendar
  • Programs
    • Camp Adventure
    • Mother’s Day Out
    • After School Programs
  • Parental Portal
  • Donations & Scholarships
  • Jobs
  • Shop
  • Contact Us
  • APPLY HERE
  • About Us
    • Our Team
    • Mission and Vision
    • Statement of Faith
  • Admissions
    • Admissions Open House
    • Admissions Process
    • Apply Online
  • Academics
    • Preschool
    • Elementary School
    • Middle School
    • High School
  • School Calendar
  • Programs
    • Camp Adventure
    • Mother’s Day Out
    • After School Programs
  • Parental Portal
  • Donations & Scholarships
  • Jobs
  • Shop
  • Contact Us
  • APPLY HERE

Enrollment Application

MM slash DD slash YYYY
Date of Admission: _____/_____/__________
Date of Withdrawal: _____/_____/__________
Campus(Required)
Choose the campus/program for which you wish to enroll. We can only process your application for the campus/program you choose.

General Information

Kingdom Heights Christian School
Dr. Terry Wright
Student Status(Required)
Child's Full Name(Required)
Child's Date of Birth(Required)
Child Lives With(Required)
Child's Home Address(Required)
Student Gender(Required)
Please enter the name, address, and phone number of the school where we can obtain the child's attendance and medical records. Enter N/A if there is no previous school attendance.
School Address(Required)
MM slash DD slash YYYY
Camp Adventure Weeks Selection(Required)
Please check the week(s) you are requesting for attendance in Camp Adventure. Our office will call you to confirm your choice(s).
Extended Care
Name of Parent or Guardian Completing Form:(Required)
Address of Parent or Guardian (if different from the child's)
Father's Name
Mother's Name
Guardian's Name
Custody Documents on File
Drop files here or
Max. file size: 1,000 MB.
    Please upload court documents indicating legal custody of the child.
    Give the name, address, and phone number of the responsible individual to call in case of an emergency if parents/ guardian cannot be reached.
    Name(Required)
    Emergency contact name:
    Emergency contact relationship to student:
    Emergency contact phone number:
    Address(Required)
    Emergency contact address:

    Authorized Individuals

    I authorize the school to release my child to leave the school ONLY with the following persons. Please list name and telephone number for each. Children will only be released to a parent or guardian or to a person designated by the parent/guardian after verification of ID.
    Name of Authorized Pickup Person(Required)
    Name of Additional Authorized Pickup Person
    Name of Additional Authorized Pickup Person

    Religious Information:

    Does your family attend church?(Required)
    Church Attending:(Required)
    Address
    Pastor's Name(Required)
    Please indicate the family members who are Christians:(Required)

    Consent Information

    1. Transportation(Required)
    I give consent for my child to be transported and supervised by the operation's employees:
    2. Field Trips(Required)
    3. Water Activities(Required)
    I give consent for my child to participate in the following water activities:
    Is your child able to swim without assistance?(Required)
    Does your child have any physical, health, behavioral or other condition that would put them at risk while swimming?(Required)
    Do you want your child to wear a life jacket while in or near a swimming pool?(Required)
    4. Receipt of Written Operational Policies(Required)
    5. Meals:
    I understand and affirm that I will provide the following meals to be served to my child while in care (Check all that apply):
    6. Days and Times in Care:(Required)
    My child is normally in care on the following days and times:
    Day of the Week
    AM
    PM
     
    Clear Signature
    Signature — Parent or Legal Guardian

    I/We, the undersigned parent(s) or guardian(s), hereby consent to my child participating in all school-related activities sponsored by Covenant Community Schools (CCS), or associated ministries while enrolled in CCS. If my/our child has medical conditions, which may be relevant to a physician in the event of an emergency, I/we have listed them below. In the event that an emergency occurs, I/we may be reached at the telephone number listed below. If I/we cannot be reached, I/we hereby authorize school personnel to make emergency medical decisions for my child. If there are any activities I/we do not want my/our child involved in, I/we have listed them below.

    I/WE UNDERSTAND AND HEREBY AGREE TO ASSUME ALL OF THE RISKS WHICH MAY BE ENCOUNTERED ON ALL SCHOOL ACTIVITIES, INCLUDING ACTIVITIES PRELIMINARY AND SUBSEQUENT THERETO. I/We do hereby agree to hold Covenant Community Schools, other related organizations, and its agent and employees, harmless from any and all liability, actions, causes of actions, claims, expenses, and damages on account of injury to my/our child or property, even injury resulting in death, which I/we now have or which may arise in the future in connection with the activity or participation in any other associated activities.

    I/We expressly agree that this release, waiver, and indemnity agreement is intended to be broad and inclusive as permitted by the law of the State of Texas and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. This release contains the entire agreement between the parties hereto and the terms of this release are contractual and not a mere recital.

    I/We further state that I/WE HAVE CAREFULLY READ THE FOREGOING RELEASE AND KNOW THE CONTENTS THEREOF AND I SIGN THIS RELEASE AS MY/OUR OWN FREE ACT.

    Consent(Required)

    Authorization for Emergency Medical Attention

    In the event I cannot be reached to make arrangements for emergency medical care, I authorize the person in charge to take my child to:
    Name of Physician
    Address
    Address
    I give consent for the facility to secure any and all necessary emergency medical care for my child.
    Clear Signature
    List any special needs that your child may have, such as environmental allergies, food intolerances, existing illness, previous serious illness, injuries and hospitalizations during the past 12 months, any medication prescribed for long-term continuous use, and any other information which caregivers should be aware of:

    Child Care Admissions Policies and Procedures

    One of the following must be presented when your child is admitted to the child care operation or within one week of admission.

    Max. file size: 1,000 MB.
    Max. file size: 1,000 MB.
    Max. file size: 1,000 MB.
    For additional information regarding immunizations, visit the Texas Department of State Health Services website at https://www.dshs.state.tx.us/immunize/public.shtm.

    Signatures

    Clear Signature
    Clear Signature
    Clear Signature
    This field is for validation purposes and should be left unchanged.
    Covenant |Private Christian School | Childcare | Round Rock TX

    Covenant Community Schools does not discriminate against members, applicants, students, and others on basis of race, color, or national or ethnic origin.

    Contact Us

    • 14 Chisholm Trail Road, Round Rock, TX 78681, United States

    • 512 255 - 7676

    • info@covenantcommunityschools.org

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