JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Blue Card 2023-24
Welcome to the 2023-2024 school year at 75 Morton!
Please fill out all of the required fields (with an *) and those that may also apply specifically to your child.
If you have more than 1 child at the school, please complete the form for each child.
* Indicates required question
Email
*
Record my email address with my response
Student LEGAL First Name
*
Your answer
Student LEGAL Last Name
*
Your answer
Student Date of Birth
*
Your answer
Student Gender
Your answer
Student Grade
*
6th
7th
8th
Does student have an IEP (Individual Education Plan)
Your answer
Does student have a 504?
Your answer
Does student have any allergies?
Yes
No
Clear selection
If student has allergies, please list them.
Your answer
Does student have any health conditions that limit participation in physical activities (i.e. running, climbing, etc)?
Yes
No
Clear selection
If student has limitations, please list them.
Your answer
Parent/Guardian #1 First Name
*
Your answer
Parent/Guardian #1 Last Name
*
Your answer
Relationship to Student
Your answer
Parent/Guardian Email Address
Your answer
Address including zip code and apartment (where student resides)
*
Your answer
Cell/Primary Phone Number
*
Your answer
Alternate Phone Number
Your answer
Parent/Guardian #2 First Name
Your answer
Parent/Guardian #2 Last Name
Your answer
Relationship to Student
Your answer
Parent/Guardian #2 Email
Your answer
Parent/Guardian #2 Cell Phone Number
Your answer
Address including zip code and apartment number (if different from Parent/Guardian #1 address)
Your answer
Emergency Contact #1 Full Name
Your answer
Relationship to Student
Your answer
Phone Number
Your answer
Emergency Contact #2 Full Name
Your answer
Relationship to Student
Your answer
Phone Number
Your answer
Emergency Contact #3 Full Name
Your answer
Relationship to Student
Your answer
Phone Number
Your answer
Emergency Contact #4 Full Name
Your answer
Relationship to Student
Your answer
Phone Number
Your answer
Emergency Contact #5 Full Name
Your answer
Relationship to Student
Your answer
Phone Number
Your answer
If we are unable to reach you or your emergency contacts, what would you like the school to do if your child is sick or injured? It is understood that in the event of an emergency, the judgement of school authorities will prevail and the recommendation of the family as indicated will be respected as far as possible.
Your answer
Name of Student's Physician
Your answer
Number for Physician/Clinic
Your answer
Type of Health Insurance for Student
Private Health Insurance
Medicaid
Child Health Plus
Clear selection
If there is someone who should NOT have access to your child, please write their full legal name.
Your answer
Is there a current Order of Protection for this person?
Yes
No
Clear selection
Sibling #1 & their current school (only K-12)
Your answer
Sibling #2 & their current school (only K-12)
Your answer
Sibling #3 & their current school (only K-12)
Your answer
I hereby consent for my child to participate in walking field trips during the 2023-2024 school year that do not require the use of mass transportation (subways, buses, etc.).
*
I hereby consent
I DO NOT consent
I hereby consent to the taking of photographs, movies, video of the student named on this form, for non-commercial purposes including use in print, the internet and all other forms of media.
*
I hereby consent
I DO NOT consent
I hereby consent for my child participate in classroom presentations with the school comfort dogs, and/or to interact directly with the school comfort dogs.
*
I hereby consent
I DO NOT consent
I understand that as a parent/guardian it is my responsibility to read the entire Family Handbook (insert link), and that I will adhere to all protocols and expectations therein.
*
Yes, I understand
My student has permission to participate in out lunch. I have reviewed the Out-Lunch Policy with my student, as stated in the Family Handbook. We understand that Out-Lunch is a privilege that can be revoked/suspended by the school or a parent/guardian at any time.
Yes, I give permission
I DO NOT give permission
Clear selection
I consent to the following information shared in the school directory. Choose the information you would like to share or choose none.
*
Child's Name
Child's Class Number
Guardian Name
Guardian Address
Guardian Email
Guardian Cell Phone
None
Required
By electronically signing this form and clicking the SUBMIT button, I am attesting that all of the information entered on this form is true and accurate. Please write your LEGAL first and last name below.
*
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of ms297.
Report Abuse
Forms