{"id":2143,"date":"2026-03-13T10:08:06","date_gmt":"2026-03-13T16:08:06","guid":{"rendered":"https:\/\/www.graniteschools.org\/preschool\/?page_id=2143"},"modified":"2026-03-23T11:18:36","modified_gmt":"2026-03-23T17:18:36","slug":"application-new","status":"publish","type":"page","link":"https:\/\/www.graniteschools.org\/preschool\/application-new\/","title":{"rendered":"Application"},"content":{"rendered":"\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\"><\/p>\n<\/blockquote>\n\n\n\n<div style=\"height:30px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"wp-block-gsd-hero-banner hero-banner p-1 p-lg-3\" style=\"width:100vw;margin-left:calc(50% - 50vw);margin-right:calc(50% - 50vw);background-color:#e8f4fc;padding-top:40px;padding-right:20px;padding-bottom:40px;padding-left:20px\">\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-8f761849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><\/div>\n\n\n\n<div class=\"wp-block-column px-2 is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:1320px\">\n<h1 class=\"wp-block-heading has-text-align-center mt-0 mb-3 text-center text-md-start has-black-color has-text-color has-link-color wp-elements-1\">Preschool Application<\/h1>\n\n\n\n<div class=\"wp-block-columns mb-0 is-layout-flex wp-container-core-columns-is-layout-8f761849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column d-flex flex-column justify-content-center is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:60%\">\n<div class=\"wp-block-group rounded p-3 mb-3 has-background\" style=\"background-color:#ffffff99\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"mb-0 text-center text-md-start wp-block-paragraph\">Complete the application below to register your child for our High Quality Preschool program. Be sure to email your supporting documents and call to pay the registration fee!<\/p>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column p-1 p-lg-3 rounded mb-0 is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:40%\"><div class=\"wp-block-image text-center\">\n<figure class=\"aligncenter size-medium is-resized\"><img loading=\"lazy\" decoding=\"async\" width=\"826\" height=\"292\" data-attachment-id=\"308\" data-permalink=\"https:\/\/www.graniteschools.org\/preschool\/new-logo-jpg\/\" data-orig-file=\"https:\/\/www.graniteschools.org\/preschool\/wp-content\/uploads\/sites\/34\/2017\/08\/new-logo-jpg.jpg\" data-orig-size=\"826,292\" data-comments-opened=\"0\" data-image-meta=\"{&quot;aperture&quot;:&quot;0&quot;,&quot;credit&quot;:&quot;&quot;,&quot;camera&quot;:&quot;&quot;,&quot;caption&quot;:&quot;&quot;,&quot;created_timestamp&quot;:&quot;0&quot;,&quot;copyright&quot;:&quot;&quot;,&quot;focal_length&quot;:&quot;0&quot;,&quot;iso&quot;:&quot;0&quot;,&quot;shutter_speed&quot;:&quot;0&quot;,&quot;title&quot;:&quot;&quot;,&quot;orientation&quot;:&quot;0&quot;}\" data-image-title=\"new logo jpg\" data-image-description=\"\" data-image-caption=\"\" data-large-file=\"https:\/\/www.graniteschools.org\/preschool\/wp-content\/uploads\/sites\/34\/2017\/08\/new-logo-jpg.jpg\" src=\"https:\/\/www.graniteschools.org\/preschool\/wp-content\/uploads\/sites\/34\/2017\/08\/new-logo-jpg.jpg\" alt=\"Granite School District Preschool\" class=\"wp-image-308\" style=\"width:300px\" srcset=\"https:\/\/www.graniteschools.org\/preschool\/wp-content\/uploads\/sites\/34\/2017\/08\/new-logo-jpg.jpg 826w, https:\/\/www.graniteschools.org\/preschool\/wp-content\/uploads\/sites\/34\/2017\/08\/new-logo-jpg-300x106.jpg 300w, https:\/\/www.graniteschools.org\/preschool\/wp-content\/uploads\/sites\/34\/2017\/08\/new-logo-jpg-768x271.jpg 768w\" sizes=\"auto, (max-width: 826px) 100vw, 826px\" \/><\/figure>\n<\/div><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><\/div>\n<\/div>\n<\/div>\n\n\n\n<div style=\"height:30px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div style=\"height:30px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"wp-block-columns mb-4 px-1 is-layout-flex wp-container-core-columns-is-layout-8f761849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div class=\"wp-block-group shadow-sm border border-1 h-100 rounded\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<h2 class=\"wp-block-gsdsc-icon m-0 text-center text-md-start p-2 rounded-top\" style=\"margin-bottom:0px;color:#000000;background-color:#f2c468\"><span class=\"icon\" style=\"margin-right:6px\"><i class=\"far fa-redo\" style=\"color:#000000\" aria-hidden=\"true\"><\/i><\/span><span>Returning Students<\/span><\/h2>\n\n\n\n<div class=\"wp-block-group p-3\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"mb-2 wp-block-paragraph\"><strong>If your child is CURRENTLY enrolled in one of our preschools:<\/strong><\/p>\n\n\n\n<p class=\"mb-0 wp-block-paragraph\">Complete the registration form below. Birth certificates and immunization records are NOT required for returning students; however, these items are required:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A $45 non-refundable <strong>registration fee<\/strong> and the first month&#8217;s tuition (if applicable). These fees can be paid by calling our office with a credit or debit card (385-646-4672). All students pay the registration fee once per year.<\/li>\n\n\n\n<li><strong>Proof of address <\/strong>(if living within the boundaries of a Limited Admission school). This must be a document in a parent&#8217;s name and must show &#8220;service address&#8221; or &#8220;property address&#8221; (gas bill, rental agreement, etc.).<\/li>\n<\/ul>\n<\/div><\/div>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\">\n<div class=\"wp-block-group shadow-sm border border-1 h-100 rounded\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<h2 class=\"wp-block-gsdsc-icon m-0 text-center text-md-start p-2 rounded-top\" style=\"margin-bottom:0px;color:#000000;background-color:#66de82\"><span class=\"icon\" style=\"margin-right:6px\"><i class=\"far fa-child\" style=\"color:#000000\" aria-hidden=\"true\"><\/i><\/span><span>New Students<\/span><\/h2>\n\n\n\n<div class=\"wp-block-group p-3\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"mb-2 wp-block-paragraph\"><strong>If your child is NEW to our program:<\/strong><\/p>\n\n\n\n<p class=\"mb-2 wp-block-paragraph\">Complete the registration form below and submit the applicable supporting documents and pay the registration fee.<\/p>\n\n\n\n<div class=\"wp-block-group p-3 rounded mb-2 has-background\" style=\"background-color:#fff3cd\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"mb-0 wp-block-paragraph\"><em><strong>Important!<\/strong> Your child will NOT be fully registered until our office receives the supporting documents and fees:<\/em><\/p>\n<\/div><\/div>\n\n\n\n<ul class=\"wp-block-list\">\n<li>A copy of the child&#8217;s <strong>birth certificate<\/strong>.<\/li>\n\n\n\n<li>A copy of the child&#8217;s <strong>UTAH immunization card<\/strong>.<\/li>\n\n\n\n<li><strong>Proof of address <\/strong>(if living within the boundaries of a Limited Admission school). This must be a document in a parent&#8217;s name and must show &#8220;service address&#8221; or &#8220;property address&#8221; (gas bill, rental agreement, etc.).<\/li>\n\n\n\n<li>A $45 non-refundable <strong>registration fee<\/strong> and the first month&#8217;s tuition (if applicable). These fees can be paid by calling our office with a credit or debit card (385-646-4672). All students pay the registration fee once per year.<\/li>\n<\/ul>\n<\/div><\/div>\n<\/div><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-group shadow-sm border border-1 rounded mb-4 px-1\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<h2 class=\"wp-block-gsdsc-icon m-0 text-center text-md-start p-2 rounded-top\" style=\"margin-bottom:0px;color:#000000;background-color:#bea1f6\"><span class=\"icon\" style=\"margin-right:6px\"><i class=\"far fa-map-marker-alt\" style=\"color:#000000\" aria-hidden=\"true\"><\/i><\/span><span>Limited Admission Schools<\/span><\/h2>\n\n\n\n<div class=\"wp-block-group p-3\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"mb-2 wp-block-paragraph\"><strong>For students registering for a Limited Admission school (<a href=\"https:\/\/www.graniteschools.org\/preschool\/our-preschools\/\" data-type=\"page\" data-id=\"1660\" target=\"_blank\" rel=\"noreferrer noopener\">see list<\/a>):<\/strong><\/p>\n\n\n\n<p class=\"mb-2 wp-block-paragraph\">Check the <a href=\"http:\/\/maps.graniteschools.org\/schoolsearch\/\" target=\"_blank\" rel=\"noreferrer noopener\">School Search Boundary Lookup<\/a> to know if this applies to you. <\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>You must also provide a copy of a <strong>Proof of Address<\/strong>. (A <em>recent<\/em> copy of an electricity, gas, or water bill in a <em>parent&#8217;s name<\/em>, or a rental agreement\/mortgage statement in a <em>parent&#8217;s name<\/em> that lists the address as a &#8220;service address&#8221; or a &#8220;property address&#8221; &#8212; no other proof of address will be accepted.)<\/li>\n<\/ul>\n<\/div><\/div>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-group p-3 rounded has-background\" style=\"background-color:#fff3cd\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<p class=\"mb-0 wp-block-paragraph\">If you are using a mobile device to complete this form, it may not send! Please use another method or call our office to confirm receipt of application.<\/p>\n<\/div><\/div>\n\n\n\n<div style=\"height:30px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"wp-block-gsd-hero-banner hero-banner p-1 p-lg-3\" style=\"width:100vw;margin-left:calc(50% - 50vw);margin-right:calc(50% - 50vw);background-color:#4076b9;padding-top:30px;padding-right:20px;padding-bottom:30px;padding-left:20px\">\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-8f761849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><\/div>\n\n\n\n<div class=\"wp-block-column px-2 is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:1320px\">\n<div class=\"wp-block-group rounded p-3 has-white-background-color has-background\"><div class=\"wp-block-group__inner-container is-layout-constrained wp-block-group-is-layout-constrained\">\n<h2 class=\"wp-block-heading m-0 mb-3 text-center\"><i class=\"far fa-edit me-2\" aria-hidden=\"true\"><\/i>Application<br><\/h2>\n\n\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof InitializeEditor,callIfLoaded:function(o){return!(!gform.domLoaded||!gform.scriptsLoaded||!gform.themeScriptsLoaded&&!gform.isFormEditor()||(gform.isFormEditor()&&console.warn(\"The use of gform.initializeOnLoaded() is deprecated in the form editor context and will be removed in Gravity Forms 3.1.\"),o(),0))},initializeOnLoaded:function(o){gform.callIfLoaded(o)||(document.addEventListener(\"gform_main_scripts_loaded\",()=>{gform.scriptsLoaded=!0,gform.callIfLoaded(o)}),document.addEventListener(\"gform\/theme\/scripts_loaded\",()=>{gform.themeScriptsLoaded=!0,gform.callIfLoaded(o)}),window.addEventListener(\"DOMContentLoaded\",()=>{gform.domLoaded=!0,gform.callIfLoaded(o)}))},hooks:{action:{},filter:{}},addAction:function(o,r,e,t){gform.addHook(\"action\",o,r,e,t)},addFilter:function(o,r,e,t){gform.addHook(\"filter\",o,r,e,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gravity-theme gform-theme--no-framework' data-form-theme='gravity-theme' data-form-index='0' id='gform_wrapper_21' style='display:none'><div id='gf_21' class='gform_anchor' tabindex='-1'><\/div>\n                        <div class='gform_heading'>\n\t\t\t\t\t\t\t<p class='gform_required_legend'>&quot;<span class=\"gfield_required gfield_required_asterisk\">*<\/span>&quot; indicates required fields<\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_21' id='gform_21'  action='\/preschool\/wp-json\/wp\/v2\/pages\/2143#gf_21' data-formid='21' novalidate>\n                        <div class='gform-body gform_body'><div id='gform_fields_21' class='gform_fields top_label form_sublabel_below description_below validation_below'><div id=\"field_21_95\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Registration Fee Acknowledgement<\/h3><\/div><fieldset id=\"field_21_293\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>The $45 fee paid at the time of registration is NON-REFUNDABLE and is required before your child can be placed in a class. All students in the preschool program are required to pay this fee.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_293'><div class='gchoice gchoice_21_293_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_293.1' type='checkbox'  value='I understand the registration fee policy'  id='choice_21_293_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_293_1' id='label_21_293_1' class='gform-field-label gform-field-label--type-inline'>I understand the registration fee policy<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_314\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Tuition Agreement<\/h3><\/div><fieldset id=\"field_21_308\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Tuition is calculated yearly and divided based on a nine-month program. Your child&#039;s monthly tuition will be determined at the time of placement and is required for participation in the program.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_308'><div class='gchoice gchoice_21_308_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_308.1' type='checkbox'  value='I understand tuition determination'  id='choice_21_308_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_308_1' id='label_21_308_1' class='gform-field-label gform-field-label--type-inline'>I understand tuition determination<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_309\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Tuition is due on the 1st of each month. You will be automatically billed and can pay tuition through your parent portal account or by contacting our office.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_309'><div class='gchoice gchoice_21_309_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_309.1' type='checkbox'  value='I understand when tuition is due'  id='choice_21_309_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_309_1' id='label_21_309_1' class='gform-field-label gform-field-label--type-inline'>I understand when tuition is due<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_310\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>You must notify the office immediately if your card information, address, phone number, or email address changes.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_310'><div class='gchoice gchoice_21_310_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_310.1' type='checkbox'  value='I agree to keep my information updated'  id='choice_21_310_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_310_1' id='label_21_310_1' class='gform-field-label gform-field-label--type-inline'>I agree to keep my information updated<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_311\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>A $10 late fee will be charged for any tuition paid after the 8th of the month.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_311'><div class='gchoice gchoice_21_311_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_311.1' type='checkbox'  value='I understand a late fee will be charged'  id='choice_21_311_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_311_1' id='label_21_311_1' class='gform-field-label gform-field-label--type-inline'>I understand a late fee will be charged<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_312\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>If the current month&#039;s tuition, plus a late fee, is not paid by the withdrawal date for that month, your child will be withdrawn and a student from the waiting list will be enrolled in your child&#039;s place.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_312'><div class='gchoice gchoice_21_312_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_312.1' type='checkbox'  value='I understand the withdrawal policy'  id='choice_21_312_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_312_1' id='label_21_312_1' class='gform-field-label gform-field-label--type-inline'>I understand the withdrawal policy<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_313\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Tuition cannot be deducted or refunded for days missed by your child due to illness, vacation, or withdrawing early. Please refer to our yearly calendar for monthly attendance dates.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_313'><div class='gchoice gchoice_21_313_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_313.1' type='checkbox'  value='I understand the refund policy'  id='choice_21_313_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_313_1' id='label_21_313_1' class='gform-field-label gform-field-label--type-inline'>I understand the refund policy<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_294\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>All withdrawals must be done through the preschool office, not via communication with teachers. If the office is not notified, YOU WILL BE BILLED for each month your child remains enrolled.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_294'><div class='gchoice gchoice_21_294_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_294.1' type='checkbox'  value='I agree to notify the office'  id='choice_21_294_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_294_1' id='label_21_294_1' class='gform-field-label gform-field-label--type-inline'>I agree to notify the office<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_315\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Payment Contract<\/h3><\/div><fieldset id=\"field_21_295\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Do you agree to enter into this agreement with Preschool Services regarding payment of tuition for your child?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_295'><div class='gchoice gchoice_21_295_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_295.1' type='checkbox'  value='Yes, I enter into the payment agreement'  id='choice_21_295_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_295_1' id='label_21_295_1' class='gform-field-label gform-field-label--type-inline'>Yes, I enter into the payment agreement<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_316\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Participation Agreement<\/h3><\/div><fieldset id=\"field_21_317\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>The school year begins in August\/September and continues through May. The preschool program is four days per week for 4-year-olds, or two days per week for 3-year-olds, and REGULAR ATTENDANCE IS EXPECTED. If your child has excessive absences or tardies, they will be dropped from the class. If your child misses days, you must notify the teacher and state the reason for the absence.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_317'><div class='gchoice gchoice_21_317_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_317.1' type='checkbox'  value='I understand and agree to the attendance policy'  id='choice_21_317_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_317_1' id='label_21_317_1' class='gform-field-label gform-field-label--type-inline'>I understand and agree to the attendance policy<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_318\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Parent participation is an important part of a child&#039;s educational success. Therefore, parents are strongly encouraged to attend parent-teacher conferences two times per year, and to attend parent\/family education opportunities to enhance their child&#039;s development of literacy and math skills.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_318'><div class='gchoice gchoice_21_318_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_318.1' type='checkbox'  value='I understand parent participation'  id='choice_21_318_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_318_1' id='label_21_318_1' class='gform-field-label gform-field-label--type-inline'>I understand parent participation<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_319\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Students who enroll in this program will be tested periodically throughout the school year to monitor academic progress.<\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_319'><div class='gchoice gchoice_21_319_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_319.1' type='checkbox'  value='I understand and agree my child will be assessed'  id='choice_21_319_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_319_1' id='label_21_319_1' class='gform-field-label gform-field-label--type-inline'>I understand and agree my child will be assessed<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_320\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Health and Human Services Client Rights Acknowledgement<\/h3><\/div><fieldset id=\"field_21_297\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Do you agree the &quot;CCL Client Rights&quot; information has been provided via the Preschool Services website (www.graniteschools.org\/preschool) and you understand its contents?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_297'><div class='gchoice gchoice_21_297_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_297.1' type='checkbox'  value='Yes, I understand Client Rights'  id='choice_21_297_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_297_1' id='label_21_297_1' class='gform-field-label gform-field-label--type-inline'>Yes, I understand Client Rights<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_321\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Disclosure Notification for School Readiness Initiative Grantees Acknowledgement<\/h3><\/div><fieldset id=\"field_21_299\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Do you agree the &quot;Disclosure Notification for School Readiness Initiative Grantees&quot; information has been provided via the Preschool Services website (www.graniteschools.org\/preschool) and you understand its contents?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_299'><div class='gchoice gchoice_21_299_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_299.1' type='checkbox'  value='Yes, I understand the disclosure notification'  id='choice_21_299_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_299_1' id='label_21_299_1' class='gform-field-label gform-field-label--type-inline'>Yes, I understand the disclosure notification<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_322\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Hearing and Vision Screening Acknowledgement<\/h3><\/div><fieldset id=\"field_21_300\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>The State of Utah mandates periodic hearing and vision screening. Granite School District performs school-wide hearing and vision screenings in each school per State Board rules and Department of Health regulations. Special education students as well as students that have been referred by teachers and parents may be screened more frequently. I understand that to exempt my child from screening, I must submit a request in writing to the Preschool Services School Nurses.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_300'><div class='gchoice gchoice_21_300_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_300.1' type='checkbox'  value='I understand the exemption policy'  id='choice_21_300_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_300_1' id='label_21_300_1' class='gform-field-label gform-field-label--type-inline'>I understand the exemption policy<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_323\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Head Injury Policy Acknowledgement<\/h3><\/div><fieldset id=\"field_21_301\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Do you agree the &quot;Head Injury Policy&quot; information has been provided via the Preschool Services website (www.graniteschools.org\/preschool) and you understand its contents?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_301'><div class='gchoice gchoice_21_301_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_301.1' type='checkbox'  value='Yes, I understand the head injury policy'  id='choice_21_301_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_301_1' id='label_21_301_1' class='gform-field-label gform-field-label--type-inline'>Yes, I understand the head injury policy<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_298\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Application Information<\/h3><\/div><fieldset id=\"field_21_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Has this child been enrolled in our program or on our waiting list before?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_6'>\n\t\t\t<div class='gchoice gchoice_21_6_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='Yes'  id='choice_21_6_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_6_0' id='label_21_6_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_6_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_6' type='radio' value='No'  id='choice_21_6_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_6_1' id='label_21_6_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_57\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">School Selection<\/h3><\/div><fieldset id=\"field_21_142\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you live within the boundaries of a Limited Admission Preschool (Title I elementary school)?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_142'>\n\t\t\t<div class='gchoice gchoice_21_142_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_142' type='radio' value='Yes'  id='choice_21_142_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_142_0' id='label_21_142_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_142_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_142' type='radio' value='No'  id='choice_21_142_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_142_1' id='label_21_142_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_52\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_52'><span class='gform-field-label__text'>Limited Admission (Title I) School Choice<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_52' id='input_21_52' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected'><\/option><option value='Academy Park Elementary' >Academy Park Elementary<\/option><option value='Farnsworth Elementary' >Farnsworth Elementary<\/option><option value='Gourley Elementary' >Gourley Elementary<\/option><option value='Granger Elementary' >Granger Elementary<\/option><option value='Hillsdale Elementary' >Hillsdale Elementary<\/option><option value='Jackling Elementary' >Jackling Elementary<\/option><option value='Lincoln Elementary' >Lincoln Elementary<\/option><option value='Magna Elementary' >Magna Elementary<\/option><option value='Monroe Elementary' >Monroe Elementary<\/option><option value='Moss Elementary' >Moss Elementary<\/option><option value='Pioneer Elementary' >Pioneer Elementary<\/option><option value='Plymouth Elementary' >Plymouth Elementary<\/option><option value='Rolling Meadows Elementary' >Rolling Meadows Elementary<\/option><option value='Silver Hills Elementary' >Silver Hills Elementary<\/option><option value='South Kearns Elementary' >South Kearns Elementary<\/option><option value='Stansbury Elementary' >Stansbury Elementary<\/option><option value='Taylorsville Elementary' >Taylorsville Elementary<\/option><option value='Walker Elementary' >Walker Elementary<\/option><option value='West Kearns Elementary (at Oquirrh Hills)' >West Kearns Elementary (at Oquirrh Hills)<\/option><option value='Wilson Elementary' >Wilson Elementary<\/option><\/select><\/div><\/div><div id=\"field_21_248\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_248'><span class='gform-field-label__text'>School Preference<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_248' id='input_21_248' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected'><\/option><option value='Arcadia Elementary' >Arcadia Elementary<\/option><option value='Armstrong Elementary' >Armstrong Elementary<\/option><option value='Beehive Elementary' >Beehive Elementary<\/option><option value='Bennion Elementary' >Bennion Elementary<\/option><option value='Bridger Elementary' >Bridger Elementary<\/option><option value='Copper Hills Elementary' >Copper Hills Elementary<\/option><option value='Driggs Elementary' >Driggs Elementary<\/option><option value='Eastwood Elementary' >Eastwood Elementary<\/option><option value='Elk Run Elementary' >Elk Run Elementary<\/option><option value='Fremont Elementary' >Fremont Elementary<\/option><option value='Hillside Elementary' >Hillside Elementary<\/option><option value='Hunter Elementary' >Hunter Elementary<\/option><option value='Oakwood Elementary' >Oakwood Elementary<\/option><option value='Pleasant Green Elementary' >Pleasant Green Elementary<\/option><option value='Rosecrest Elementary' >Rosecrest Elementary<\/option><option value='Smith Elementary' >Smith Elementary<\/option><option value='Truman Elementary' >Truman Elementary<\/option><option value='Upland Terrace Elementary' >Upland Terrace Elementary<\/option><option value='Vista Elementary' >Vista Elementary<\/option><option value='West Valley Elementary' >West Valley Elementary<\/option><option value='Whittier Elementary' >Whittier Elementary<\/option><option value='Woodstock Elementary' >Woodstock Elementary<\/option><option value='Wright Elementary' >Wright Elementary<\/option><\/select><\/div><\/div><div id=\"field_21_249\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_249'><span class='gform-field-label__text'>If space is not available at your preferred school, what is your 2nd choice?<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_249' id='input_21_249' class='medium gfield_select'     aria-invalid=\"false\" ><option value='' selected='selected'><\/option><option value='Arcadia Elementary' >Arcadia Elementary<\/option><option value='Armstrong Elementary' >Armstrong Elementary<\/option><option value='Beehive Elementary' >Beehive Elementary<\/option><option value='Bennion Elementary' >Bennion Elementary<\/option><option value='Bridger Elementary' >Bridger Elementary<\/option><option value='Copper Hills Elementary' >Copper Hills Elementary<\/option><option value='Driggs Elementary' >Driggs Elementary<\/option><option value='Eastwood Elementary' >Eastwood Elementary<\/option><option value='Elk Run Elementary' >Elk Run Elementary<\/option><option value='Fremont Elementary' >Fremont Elementary<\/option><option value='Hillside Elementary' >Hillside Elementary<\/option><option value='Hunter Elementary' >Hunter Elementary<\/option><option value='Oakwood Elementary' >Oakwood Elementary<\/option><option value='Pleasant Green Elementary' >Pleasant Green Elementary<\/option><option value='Rosecrest Elementary' >Rosecrest Elementary<\/option><option value='Smith Elementary' >Smith Elementary<\/option><option value='Truman Elementary' >Truman Elementary<\/option><option value='Upland Terrace Elementary' >Upland Terrace Elementary<\/option><option value='Vista Elementary' >Vista Elementary<\/option><option value='West Valley Elementary' >West Valley Elementary<\/option><option value='Whittier Elementary' >Whittier Elementary<\/option><option value='Woodstock Elementary' >Woodstock Elementary<\/option><option value='Wright Elementary' >Wright Elementary<\/option><\/select><\/div><\/div><fieldset id=\"field_21_276\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Which do you prefer?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_276'>\n\t\t\t<div class='gchoice gchoice_21_276_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_276' type='radio' value='mornings'  id='choice_21_276_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_276_0' id='label_21_276_0' class='gform-field-label gform-field-label--type-inline'>mornings<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_276_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_276' type='radio' value='afternoons'  id='choice_21_276_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_276_1' id='label_21_276_1' class='gform-field-label gform-field-label--type-inline'>afternoons<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_276_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_276' type='radio' value='any'  id='choice_21_276_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_276_2' id='label_21_276_2' class='gform-field-label gform-field-label--type-inline'>any<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_64\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_64'><span class='gform-field-label__text'>Other Requests<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_64' id='input_21_64' type='text' value='' class='large'  aria-describedby=\"gfield_description_21_64\"    aria-invalid=\"false\"   \/><\/div><div class='gfield_description' id='gfield_description_21_64'>(i.e., days of the week, teacher preference, placement with a sibling, etc.)<\/div><\/div><fieldset id=\"field_21_175\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden gfield--choice-align-vertical\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Do you have younger children at home (0-3 years old)?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_175'>\n\t\t\t<div class='gchoice gchoice_21_175_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_175' type='radio' value='Yes'  id='choice_21_175_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_175_0' id='label_21_175_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_175_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_175' type='radio' value='No'  id='choice_21_175_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_175_1' id='label_21_175_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_176\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_hidden gfield--choice-align-vertical\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Would you like to help prepare your younger children for preschool?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_21_176'>We are excited to partner with Help Me Grow Utah to connect you with this information.  They provide free developmental screenings and resources to support your younger child&#8217;s development.  Please mark below to give us permission to share your contact information with Help Me Grow Utah.<\/div><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_176'><div class='gchoice gchoice_21_176_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_176.1' type='checkbox'  value='Yes, I want more information to support my younger child&#039;s development'  id='choice_21_176_1'   aria-describedby=\"gfield_description_21_176\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_21_176_1' id='label_21_176_1' class='gform-field-label gform-field-label--type-inline'>Yes, I want more information to support my younger child&#8217;s development<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_21_176_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_176.2' type='checkbox'  value='No, I do not want to share my contact information'  id='choice_21_176_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_176_2' id='label_21_176_2' class='gform-field-label gform-field-label--type-inline'>No, I do not want to share my contact information<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_134\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Funding Source<\/h3><\/div><div id=\"field_21_136\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  >Our preschool&#8217;s financial support comes from multiple sources.  To determine your child&#8217;s funding sources beyond tuition, please answer the following questions.<\/div><fieldset id=\"field_21_135\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Does your family qualify for free or reduced lunch?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_135'><div class='gchoice gchoice_21_135_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_135.1' type='checkbox'  value='Yes - free or reduced lunch qualified'  id='choice_21_135_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_135_1' id='label_21_135_1' class='gform-field-label gform-field-label--type-inline'>Yes &#8211; free or reduced lunch qualified<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_21_135_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_135.2' type='checkbox'  value='No, not free or reduced lunch qualified'  id='choice_21_135_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_135_2' id='label_21_135_2' class='gform-field-label gform-field-label--type-inline'>No, not free or reduced lunch qualified<\/label>\n\t\t\t\t\t\t\t<\/div><div class='gchoice gchoice_21_135_3'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_135.3' type='checkbox'  value='I don&#039;t know'  id='choice_21_135_3'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_135_3' id='label_21_135_3' class='gform-field-label gform-field-label--type-inline'>I don&#8217;t know<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_178\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How many people live in your household?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_178'>\n\t\t\t<div class='gchoice gchoice_21_178_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_178' type='radio' value='2'  id='choice_21_178_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_178_0' id='label_21_178_0' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_178_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_178' type='radio' value='3'  id='choice_21_178_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_178_1' id='label_21_178_1' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_178_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_178' type='radio' value='4'  id='choice_21_178_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_178_2' id='label_21_178_2' class='gform-field-label gform-field-label--type-inline'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_178_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_178' type='radio' value='5'  id='choice_21_178_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_178_3' id='label_21_178_3' class='gform-field-label gform-field-label--type-inline'>5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_178_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_178' type='radio' value='6'  id='choice_21_178_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_178_4' id='label_21_178_4' class='gform-field-label gform-field-label--type-inline'>6<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_178_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_178' type='radio' value='7'  id='choice_21_178_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_178_5' id='label_21_178_5' class='gform-field-label gform-field-label--type-inline'>7<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_178_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_178' type='radio' value='8'  id='choice_21_178_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_178_6' id='label_21_178_6' class='gform-field-label gform-field-label--type-inline'>8<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_178_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_178' type='radio' value='more than 8'  id='choice_21_178_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_178_7' id='label_21_178_7' class='gform-field-label gform-field-label--type-inline'>more than 8<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_179\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is the gross (before tax) household income less than $3,336 per month?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_179'>\n\t\t\t<div class='gchoice gchoice_21_179_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_179' type='radio' value='yes'  id='choice_21_179_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_179_0' id='label_21_179_0' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_179_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_179' type='radio' value='no'  id='choice_21_179_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_179_1' id='label_21_179_1' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_180\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is the gross (before tax) household income less than $4,211 per month?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_180'>\n\t\t\t<div class='gchoice gchoice_21_180_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_180' type='radio' value='yes'  id='choice_21_180_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_180_0' id='label_21_180_0' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_180_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_180' type='radio' value='no'  id='choice_21_180_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_180_1' id='label_21_180_1' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_181\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is the gross (before tax) household income less than $5,087 per month?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_181'>\n\t\t\t<div class='gchoice gchoice_21_181_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_181' type='radio' value='yes'  id='choice_21_181_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_181_0' id='label_21_181_0' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_181_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_181' type='radio' value='no'  id='choice_21_181_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_181_1' id='label_21_181_1' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_182\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is the gross (before tax) household income less than $5,963 per month?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_182'>\n\t\t\t<div class='gchoice gchoice_21_182_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_182' type='radio' value='yes'  id='choice_21_182_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_182_0' id='label_21_182_0' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_182_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_182' type='radio' value='no'  id='choice_21_182_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_182_1' id='label_21_182_1' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_183\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is the gross (before tax) household income less than $6,839 per month?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_183'>\n\t\t\t<div class='gchoice gchoice_21_183_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_183' type='radio' value='yes'  id='choice_21_183_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_183_0' id='label_21_183_0' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_183_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_183' type='radio' value='no'  id='choice_21_183_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_183_1' id='label_21_183_1' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_184\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is the gross (before tax) household income less than $7,714 per month?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_184'>\n\t\t\t<div class='gchoice gchoice_21_184_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_184' type='radio' value='yes'  id='choice_21_184_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_184_0' id='label_21_184_0' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_184_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_184' type='radio' value='no'  id='choice_21_184_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_184_1' id='label_21_184_1' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_185\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is the gross (before tax) household income less than $8,590 per month?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_185'>\n\t\t\t<div class='gchoice gchoice_21_185_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_185' type='radio' value='yes'  id='choice_21_185_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_185_0' id='label_21_185_0' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_185_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_185' type='radio' value='no'  id='choice_21_185_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_185_1' id='label_21_185_1' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_259\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How many of these circumstances apply to your preschooler?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='gfield_description' id='gfield_description_21_259'><b>READ THE LIST BELOW AND COUNT HOW MANY OF THESE CIRCUMSTANCES APPLY TO YOUR PRESCHOOLER:<\/b>\n<ul>\n  <li>Child born to mother who was 18 years old or younger<\/li>\n  <li>A member of child&#8217;s household is incarcerated<\/li>\n  <li>Child lives in a neighborhood with high violence\/crime<\/li>\n  <li>One or both parents have a low reading ability<\/li>\n  <li>Family has moved at least once in the last year<\/li>\n  <li>Child has ever been in foster care<\/li>\n  <li>Lives in a household with multiple families<\/li>\n  <li>Child exposed to physical abuse or domestic violence in the home at any time in their life<\/li>\n  <li>Child exposed to substance abuse (drugs or alcohol) in the home at any point in their life<\/li>\n  <li>Child exposed to stressful life events (death, chronic illness or mental health issues of a parent or sibling)<\/li>\n  <li>Language spoken in the home most often is NOT English<\/li>\n  <li>A parent of the child did not graduate from high school<\/li>\n<\/ul>\n<\/div><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_259'>\n\t\t\t<div class='gchoice gchoice_21_259_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_259' type='radio' value='0'  id='choice_21_259_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_21_259\"   \/>\n\t\t\t\t\t<label for='choice_21_259_0' id='label_21_259_0' class='gform-field-label gform-field-label--type-inline'>0<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_259_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_259' type='radio' value='1'  id='choice_21_259_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_259_1' id='label_21_259_1' class='gform-field-label gform-field-label--type-inline'>1<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_259_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_259' type='radio' value='2'  id='choice_21_259_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_259_2' id='label_21_259_2' class='gform-field-label gform-field-label--type-inline'>2<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_259_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_259' type='radio' value='3'  id='choice_21_259_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_259_3' id='label_21_259_3' class='gform-field-label gform-field-label--type-inline'>3<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_259_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_259' type='radio' value='4'  id='choice_21_259_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_259_4' id='label_21_259_4' class='gform-field-label gform-field-label--type-inline'>4<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_259_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_259' type='radio' value='5'  id='choice_21_259_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_259_5' id='label_21_259_5' class='gform-field-label gform-field-label--type-inline'>5<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_259_6'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_259' type='radio' value='6'  id='choice_21_259_6' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_259_6' id='label_21_259_6' class='gform-field-label gform-field-label--type-inline'>6<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_259_7'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_259' type='radio' value='7'  id='choice_21_259_7' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_259_7' id='label_21_259_7' class='gform-field-label gform-field-label--type-inline'>7<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_259_8'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_259' type='radio' value='8'  id='choice_21_259_8' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_259_8' id='label_21_259_8' class='gform-field-label gform-field-label--type-inline'>8<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_259_9'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_259' type='radio' value='9'  id='choice_21_259_9' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_259_9' id='label_21_259_9' class='gform-field-label gform-field-label--type-inline'>9<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_259_10'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_259' type='radio' value='10'  id='choice_21_259_10' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_259_10' id='label_21_259_10' class='gform-field-label gform-field-label--type-inline'>10<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_259_11'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_259' type='radio' value='11'  id='choice_21_259_11' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_259_11' id='label_21_259_11' class='gform-field-label gform-field-label--type-inline'>11<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_259_12'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_259' type='radio' value='12'  id='choice_21_259_12' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_259_12' id='label_21_259_12' class='gform-field-label gform-field-label--type-inline'>12<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_274\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is the child currently in Foster Care?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_274'>\n\t\t\t<div class='gchoice gchoice_21_274_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_274' type='radio' value='no'  id='choice_21_274_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_274_0' id='label_21_274_0' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_274_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_274' type='radio' value='yes'  id='choice_21_274_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_274_1' id='label_21_274_1' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_273\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is your child an English Learner? (see definition below)?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_273'>\n\t\t\t<div class='gchoice gchoice_21_273_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_273' type='radio' value='no'  id='choice_21_273_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_21_273\"   \/>\n\t\t\t\t\t<label for='choice_21_273_0' id='label_21_273_0' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_273_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_273' type='radio' value='yes'  id='choice_21_273_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_273_1' id='label_21_273_1' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_21_273'>The child:<\/br>\n&#8211; was not born in the United States, or whose native language is NOT English, or<\/br>\n&#8211; is a Native American or Alaska Native, or a native resident of the outlying areas and comes from an environment where a language other than English has had a significant impact on their level of English Language proficiency, or<\/br>\n&#8211; is migratory, whose native language is NOT English and who comes from an environment where a language other than English is dominant<\/br>\nAND<\/br>\nhas difficulties in speaking reading, writing, or understanding the English language that may be sufficient to deny the child the ability to meet challenging state academic standards or successfully achieve in English-instructed classrooms, or the opportunity to participate fully in society.<\/div><\/fieldset><div id=\"field_21_16\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Child&#039;s Information<\/h3><\/div><div id=\"field_21_172\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_172'><span class='gform-field-label__text'>Legal FIRST Name (Primer Nombre)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_172' id='input_21_172' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_173\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_173'><span class='gform-field-label__text'>Legal MIDDLE Name<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_173' id='input_21_173' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_174\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_174'><span class='gform-field-label__text'>Legal LAST Name (Apellido)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_174' id='input_21_174' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_18\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Child&#039;s Gender<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_18'>\n\t\t\t<div class='gchoice gchoice_21_18_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='F'  id='choice_21_18_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_18_0' id='label_21_18_0' class='gform-field-label gform-field-label--type-inline'>Female<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_18_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_18' type='radio' value='M'  id='choice_21_18_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_18_1' id='label_21_18_1' class='gform-field-label gform-field-label--type-inline'>Male<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_133\" class=\"gfield gfield--type-date gfield--input-type-date gfield--input-type-datefield gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Child&#039;s Birthdate<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div id='input_21_133' class='ginput_container ginput_complex gform-grid-row'><div class='gfield_date_month ginput_container ginput_container_date gform-grid-col' id='input_21_133_1_container'>\n                                        <input type='number' maxlength='2' name='input_133[]' id='input_21_133_1' value=''   aria-required='true'   placeholder='MM' min='1' max='12' step='1'\/>\n                                        <label for='input_21_133_1' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Month<\/label>\n                                    <\/div><div class='gfield_date_day ginput_container ginput_container_date gform-grid-col' id='input_21_133_2_container'>\n                                        <input type='number' maxlength='2' name='input_133[]' id='input_21_133_2' value=''   aria-required='true'   placeholder='DD' min='1' max='31' step='1'\/>\n                                        <label for='input_21_133_2' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Day<\/label>\n                                    <\/div><div class='gfield_date_year ginput_container ginput_container_date gform-grid-col' id='input_21_133_3_container'>\n                                        <input type='number' maxlength='4' name='input_133[]' id='input_21_133_3' value=''   aria-required='true'   placeholder='YYYY' min='1920' max='2027' step='1'\/>\n                                        <label for='input_21_133_3' class='gform-field-label gform-field-label--type-sub screen-reader-text'>Year<\/label>\n                                   <\/div>\n                               <\/div><\/fieldset><fieldset id=\"field_21_190\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Child&#039;s Age on September 1, 2026:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_190'>\n\t\t\t<div class='gchoice gchoice_21_190_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_190' type='radio' value='2 years old'  id='choice_21_190_0' onchange='gformToggleRadioOther( this )' aria-describedby=\"gfield_description_21_190\"   \/>\n\t\t\t\t\t<label for='choice_21_190_0' id='label_21_190_0' class='gform-field-label gform-field-label--type-inline'>2 years old<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_190_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_190' type='radio' value='3 years old'  id='choice_21_190_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_190_1' id='label_21_190_1' class='gform-field-label gform-field-label--type-inline'>3 years old<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_190_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_190' type='radio' value='4 years old'  id='choice_21_190_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_190_2' id='label_21_190_2' class='gform-field-label gform-field-label--type-inline'>4 years old<\/label>\n\t\t\t<\/div><\/div><\/div><div class='gfield_description' id='gfield_description_21_190'>If your child is 5+ years old on this date, they must register for kindergarten. Please contact your local school.<\/div><\/fieldset><div id=\"field_21_145\" class=\"gfield gfield--type-select gfield--input-type-select field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_145'><span class='gform-field-label__text'>If your child will NOT be turning 3 during the next month, you must wait to complete this registration.  Otherwise, please select one of the following schools that offer a Young 3s program:<\/span><\/label><div class='ginput_container ginput_container_select'><select name='input_145' id='input_21_145' class='medium gfield_select'     aria-invalid=\"false\" ><option value='Academy Park Elementary' >Academy Park Elementary<\/option><option value='Arcadia Elementary' >Arcadia Elementary<\/option><option value='Eastwood Elementary' >Eastwood Elementary<\/option><option value='Hillsdale Elementary' >Hillsdale Elementary<\/option><option value='Jackling Elementary' >Jackling Elementary<\/option><option value='Lincoln Elementary' >Lincoln Elementary<\/option><option value='Pleasant Green Elementary' >Pleasant Green Elementary<\/option><option value='Silver Hills Elementary' >Silver Hills Elementary<\/option><\/select><\/div><\/div><fieldset id=\"field_21_11\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Child&#039;s PRIMARY Race \/ Ethnicity<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_11'>\n\t\t\t<div class='gchoice gchoice_21_11_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='A'  id='choice_21_11_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_11_0' id='label_21_11_0' class='gform-field-label gform-field-label--type-inline'>Asian<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_11_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='B'  id='choice_21_11_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_11_1' id='label_21_11_1' class='gform-field-label gform-field-label--type-inline'>Black<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_11_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='C'  id='choice_21_11_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_11_2' id='label_21_11_2' class='gform-field-label gform-field-label--type-inline'>Caucasian<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_11_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='H'  id='choice_21_11_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_11_3' id='label_21_11_3' class='gform-field-label gform-field-label--type-inline'>Hispanic \/ Latino<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_11_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='P'  id='choice_21_11_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_11_4' id='label_21_11_4' class='gform-field-label gform-field-label--type-inline'>Pacific Islander<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_11_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_11' type='radio' value='I'  id='choice_21_11_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_11_5' id='label_21_11_5' class='gform-field-label gform-field-label--type-inline'>Native American \/ Alaskan Native<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_19\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_19'><span class='gform-field-label__text'>What language does the child speak most often? (If they do not yet speak, what language is most often spoken at home?)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_19' id='input_21_19' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_21\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_21'><span class='gform-field-label__text'>What language did the child learn first? (If they do not yet speak, what language is most often spoken at home?)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_21' id='input_21_21' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_20\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_20'><span class='gform-field-label__text'>Does the student have the opportunity to hear\/speak another language? If so, which language:<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_20' id='input_21_20' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_290\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_290'><span class='gform-field-label__text'>What is the primary language used in the home, regardless of the language spoken by the student?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_290' id='input_21_290' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_285\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>What language do you prefer for school-to-home information?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_285'>\n\t\t\t<div class='gchoice gchoice_21_285_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_285' type='radio' value='English'  id='choice_21_285_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_285_0' id='label_21_285_0' class='gform-field-label gform-field-label--type-inline'>English<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_285_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_285' type='radio' value='Spanish'  id='choice_21_285_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_285_1' id='label_21_285_1' class='gform-field-label gform-field-label--type-inline'>Spanish<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_12\" class=\"gfield gfield--type-list gfield--input-type-list field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Please list any brothers and sisters living at home.<\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Birthdate<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_12_cell1 gform-grid-col' data-label='Name'><input aria-invalid='false'  aria-describedby=\"gfield_description_21_12\" aria-label='Name, Row 1' data-aria-label-template='Name, Row {0}' type='text' name='input_12[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_12_cell2 gform-grid-col' data-label='Birthdate'><input aria-invalid='false'  aria-describedby=\"gfield_description_21_12\" aria-label='Birthdate, Row 1' data-aria-label-template='Birthdate, Row {0}' type='text' name='input_12[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><div class='gfield_description' id='gfield_description_21_12'>To add additional siblings, please click the &#8220;+&#8221; button.<\/div><\/fieldset><fieldset id=\"field_21_15\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>With whom does the child live?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_15'>\n\t\t\t<div class='gchoice gchoice_21_15_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Both Mother and Father'  id='choice_21_15_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_15_0' id='label_21_15_0' class='gform-field-label gform-field-label--type-inline'>Both Mother and Father<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_15_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Mother'  id='choice_21_15_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_15_1' id='label_21_15_1' class='gform-field-label gform-field-label--type-inline'>Mother<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_15_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='Father'  id='choice_21_15_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_15_2' id='label_21_15_2' class='gform-field-label gform-field-label--type-inline'>Father<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_15_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_15' type='radio' value='gf_other_choice'  id='choice_21_15_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_15_3' id='label_21_15_3' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_21_15_other' class='gchoice_other_control' name='input_15_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_17\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Primary Contact Information (Parent or Legal Guardian)<\/h3><\/div><div id=\"field_21_158\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_158'><span class='gform-field-label__text'>Primary Contact&#039;s First Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_158' id='input_21_158' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_159\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_159'><span class='gform-field-label__text'>Primary Contact&#039;s Last Name<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_159' id='input_21_159' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_160\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_160'><span class='gform-field-label__text'>Primary Contact&#039;s Street Address<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_160' id='input_21_160' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_266\" class=\"gfield gfield--type-text gfield--input-type-text gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_266'><span class='gform-field-label__text'>Apartment #<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_266' id='input_21_266' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_161\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_161'><span class='gform-field-label__text'>Primary Contact&#039;s City<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_161' id='input_21_161' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_162\" class=\"gfield gfield--type-text gfield--input-type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_162'><span class='gform-field-label__text'>Primary Contact&#039;s Zip Code<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_162' id='input_21_162' type='text' value='' class='medium'    placeholder='99999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"99999\"\/><\/div><\/div><div id=\"field_21_26\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_26'><span class='gform-field-label__text'>Primary Contact&#039;s Relationship to Student<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_26' id='input_21_26' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_28\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_28'><span class='gform-field-label__text'>Primary Contact&#039;s Cell Phone Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_28' id='input_21_28' type='tel' value='' class='medium'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_21_27\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gf_right_half gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_27'><span class='gform-field-label__text'>Primary Contact&#039;s Home Phone Number<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_27' id='input_21_27' type='tel' value='' class='medium'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_21_29\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gf_right_half gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_29'><span class='gform-field-label__text'>Primary Contact&#039;s Work Phone Number<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_29' id='input_21_29' type='tel' value='' class='medium'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><fieldset id=\"field_21_30\" class=\"gfield gfield--type-email gfield--input-type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Primary Contact&#039;s Email Address &#8211; THIS IS IMPORTANT: Most preschool communication will be sent via parent portal and\/or email. To assist you in creating a parent portal account, we must have an accurate email address.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_complex ginput_container ginput_container_email gform-grid-row' id='input_21_30_container'>\n                                <span id='input_21_30_1_container' class='ginput_left gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_30' id='input_21_30' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_21_30' class='gform-field-label gform-field-label--type-sub '>Enter Email<\/label>\n                                <\/span>\n                                <span id='input_21_30_2_container' class='ginput_right gform-grid-col gform-grid-col--size-auto'>\n                                    <input class='' type='email' name='input_30_2' id='input_21_30_2' value=''    aria-required=\"true\" aria-invalid=\"false\"  \/>\n                                    <label for='input_21_30_2' class='gform-field-label gform-field-label--type-sub '>Confirm Email<\/label>\n                                <\/span>\n                                <div class='gf_clear gf_clear_complex'><\/div>\n                            <\/div><\/fieldset><div id=\"field_21_31\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Secondary Contact Information (Parent or Legal Guardian)<\/h3><\/div><div id=\"field_21_163\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_163'><span class='gform-field-label__text'>Secondary Contact&#039;s First Name<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_163' id='input_21_163' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_164\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_164'><span class='gform-field-label__text'>Secondary Contact&#039;s Last Name<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_164' id='input_21_164' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_165\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_165'><span class='gform-field-label__text'>Secondary Contact&#039;s Street Address<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_165' id='input_21_165' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_166\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_166'><span class='gform-field-label__text'>Secondary Contact&#039;s City<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_166' id='input_21_166' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_167\" class=\"gfield gfield--type-text gfield--input-type-text field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_167'><span class='gform-field-label__text'>Secondary Contact&#039;s Zip Code<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_167' id='input_21_167' type='text' value='' class='medium'    placeholder='99999'  aria-invalid=\"false\"   data-mask=\"99999\"\/><\/div><\/div><div id=\"field_21_34\" class=\"gfield gfield--type-text gfield--input-type-text gf_left_half gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_34'><span class='gform-field-label__text'>Secondary Contact&#039;s Relationship to Student<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_34' id='input_21_34' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_36\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gf_left_half gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_36'><span class='gform-field-label__text'>Secondary Contact&#039;s Cell Phone Number<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_36' id='input_21_36' type='tel' value='' class='medium'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_21_35\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gf_right_half gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_35'><span class='gform-field-label__text'>Secondary Contact&#039;s Home Phone Number<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_35' id='input_21_35' type='tel' value='' class='medium'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_21_39\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gf_right_half gfield--width-half field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_39'><span class='gform-field-label__text'>Secondary Contact&#039;s Work Phone Number<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_39' id='input_21_39' type='tel' value='' class='medium'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><div id=\"field_21_37\" class=\"gfield gfield--type-email gfield--input-type-email field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_37'><span class='gform-field-label__text'>Secondary Contact&#039;s Email<\/span><\/label><div class='ginput_container ginput_container_email'>\n                            <input name='input_37' id='input_21_37' type='email' value='' class='large'     aria-invalid=\"false\"  \/>\n                        <\/div><\/div><div id=\"field_21_58\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Emergency Information<\/h3><\/div><div id=\"field_21_119\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p class=\"gfield_label\">Please provide up to three emergency contacts other than those listed above.<\/p><\/div><div id=\"field_21_117\" class=\"gfield gfield--type-text gfield--input-type-text gf_middle_third gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_117'><span class='gform-field-label__text'>Emergency Contact&#039;s Full Name (please list someone not listed above)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_117' id='input_21_117' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_168\" class=\"gfield gfield--type-text gfield--input-type-text gf_middle_third gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_168'><span class='gform-field-label__text'>Emergency Contact&#039;s Relationship to Student<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_168' id='input_21_168' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_118\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gf_right_third gfield--width-third gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_118'><span class='gform-field-label__text'>Emergency Contact&#039;s Phone Number<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_118' id='input_21_118' type='tel' value='' class='medium'  placeholder='(999) 999-9999' aria-required=\"true\" aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><fieldset id=\"field_21_277\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is this emergency contact also permitted to pick up the student from school?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_277'>\n\t\t\t<div class='gchoice gchoice_21_277_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_277' type='radio' value='yes'  id='choice_21_277_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_277_0' id='label_21_277_0' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_277_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_277' type='radio' value='no'  id='choice_21_277_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_277_1' id='label_21_277_1' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_170\" class=\"gfield gfield--type-text gfield--input-type-text gf_middle_third gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_170'><span class='gform-field-label__text'>Full Name &#8211; Emergency Contact 2<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_170' id='input_21_170' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_122\" class=\"gfield gfield--type-text gfield--input-type-text gf_middle_third gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_122'><span class='gform-field-label__text'>Relationship to Student<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_122' id='input_21_122' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_124\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gf_right_third gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_124'><span class='gform-field-label__text'>Phone<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_124' id='input_21_124' type='tel' value='' class='medium'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><fieldset id=\"field_21_278\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is this emergency contact also permitted to pick up the student from school?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_278'>\n\t\t\t<div class='gchoice gchoice_21_278_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_278' type='radio' value='yes'  id='choice_21_278_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_278_0' id='label_21_278_0' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_278_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_278' type='radio' value='no'  id='choice_21_278_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_278_1' id='label_21_278_1' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_263\" class=\"gfield gfield--type-text gfield--input-type-text gf_middle_third gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_263'><span class='gform-field-label__text'>Full Name &#8211; Emergency Contact 3<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_263' id='input_21_263' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_262\" class=\"gfield gfield--type-text gfield--input-type-text gf_middle_third gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_262'><span class='gform-field-label__text'>Relationship to Student<\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_262' id='input_21_262' type='text' value='' class='medium'      aria-invalid=\"false\"   \/><\/div><\/div><div id=\"field_21_125\" class=\"gfield gfield--type-phone gfield--input-type-phone gfield--phone-format-standard gf_right_third gfield--width-third field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_125'><span class='gform-field-label__text'>Phone<\/span><\/label><div class='ginput_container ginput_container_phone'><input name='input_125' id='input_21_125' type='tel' value='' class='medium'  placeholder='(999) 999-9999'  aria-invalid=\"false\"   data-mask=\"(999) 999-9999\" \/><\/div><\/div><fieldset id=\"field_21_279\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gfield--width-full field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is this emergency contact also permitted to pick up the student from school?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_279'>\n\t\t\t<div class='gchoice gchoice_21_279_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_279' type='radio' value='yes'  id='choice_21_279_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_279_0' id='label_21_279_0' class='gform-field-label gform-field-label--type-inline'>yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_279_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_279' type='radio' value='no'  id='choice_21_279_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_279_1' id='label_21_279_1' class='gform-field-label gform-field-label--type-inline'>no<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_63\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Restrictions<\/h3><\/div><div id=\"field_21_286\" class=\"gfield gfield--type-textarea gfield--input-type-textarea gfield--width-full field_sublabel_below gfield--has-description field_description_above field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_286'><span class='gform-field-label__text'>Pick Up Restrictions &#8211; NOT allowed to pick up student<\/span><\/label><div class='gfield_description' id='gfield_description_21_286'><strong>If you have a LEGAL DOCUMENT restricting someone from contact with your child, please list that person here and provide a copy of the document along with the other required registration materials. If there is no legal document, do not list anyone here. <\/strong>Please include the person&#8217;s name, relationship to the student, and phone number if available. Use a separate line for each person. <\/div><div class='ginput_container ginput_container_textarea'><textarea name='input_286' id='input_21_286' class='textarea large'  aria-describedby=\"gfield_description_21_286\"    aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><\/div><\/div><fieldset id=\"field_21_280\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Name<\/span><\/legend><div class='ginput_container ginput_container_list ginput_list '><div class='gfield_list gfield_list_container'><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_280_cell1 gform-grid-col' ><input aria-invalid='false'  aria-describedby=\"gfield_description_21_280\" aria-label='Name, Row 1' data-aria-label-template='Name, Row {0}' type='text' name='input_280[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><div class='gfield_description' id='gfield_description_21_280'><strong>If you have a LEGAL DOCUMENT restricting someone from contact with your child, please list that person here and provide a copy of the document along with other registrations materials. If there is no legal document, do not list anyone here.<\/strong><\/div><\/fieldset><fieldset id=\"field_21_282\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Relationship to Child<\/span><\/legend><div class='ginput_container ginput_container_list ginput_list '><div class='gfield_list gfield_list_container'><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_282_cell1 gform-grid-col' ><input aria-invalid='false'  aria-describedby=\"gfield_description_21_282\" aria-label='Relationship to Child, Row 1' data-aria-label-template='Relationship to Child, Row {0}' type='text' name='input_282[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><div class='gfield_description' id='gfield_description_21_282'>Pick Up Restrictions &#8211; NOT allowed to pick up student &#8211; <strong>If you have a LEGAL DOCUMENT restricting someone from contact with your child, please list that person here and provide a copy of the document along with other registrations materials. If there is no legal document, do not list anyone here.<\/strong><\/div><\/fieldset><fieldset id=\"field_21_281\" class=\"gfield gfield--type-list gfield--input-type-list gfield--width-full field_sublabel_below gfield--has-description field_description_below field_validation_below gfield_visibility_hidden\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Phone Number<\/span><\/legend><div class='ginput_container ginput_container_list ginput_list '><div class='gfield_list gfield_list_container'><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_281_cell1 gform-grid-col' ><input aria-invalid='false'  aria-describedby=\"gfield_description_21_281\" aria-label='Phone Number, Row 1' data-aria-label-template='Phone Number, Row {0}' type='text' name='input_281[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><div class='gfield_description' id='gfield_description_21_281'>Pick Up Restrictions &#8211; NOT allowed to pick up student &#8211; <strong>If you have a LEGAL DOCUMENT restricting someone from contact with your child, please list that person here and provide a copy of the document along with other registrations materials. If there is no legal document, do not list anyone here.<\/strong><\/div><\/fieldset><div id=\"field_21_65\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Health Information<\/h3><\/div><fieldset id=\"field_21_66\" class=\"gfield gfield--type-list gfield--input-type-list field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Physician and\/or Specialist Details<\/span><\/legend><div class='ginput_container ginput_container_list ginput_list ginput_container_list--columns'><div class='gfield_list gfield_list_container'><div class=\"gfield_list_header gform-grid-row\"><div class=\"gform-field-label gfield_header_item gform-grid-col\">Name<\/div><div class=\"gform-field-label gfield_header_item gform-grid-col\">Phone #<\/div><div class=\"gfield_header_item gfield_header_item--icons gform-grid-col\">&nbsp;<\/div><\/div><div class=\"gfield_list_groups\"><div class='gfield_list_row_odd gfield_list_group gform-grid-row'><div class='gfield_list_group_item gfield_list_cell gfield_list_66_cell1 gform-grid-col' data-label='Name'><input aria-invalid='false'   aria-label='Name, Row 1' data-aria-label-template='Name, Row {0}' type='text' name='input_66[]' value=''   \/><\/div><div class='gfield_list_group_item gfield_list_cell gfield_list_66_cell2 gform-grid-col' data-label='Phone #'><input aria-invalid='false'   aria-label='Phone #, Row 1' data-aria-label-template='Phone #, Row {0}' type='text' name='input_66[]' value=''   \/><\/div><div class='gfield_list_icons gform-grid-col'>   <button type='button'  class='add_list_item ' aria-label='Add another row' onclick='gformAddListItem(this, 0)'>Add<\/button>   <button type='button'  class='delete_list_item' aria-label='Remove row 1' data-aria-label-template='Remove row {0}' onclick='gformDeleteListItem(this, 0)' style=\"visibility:hidden;\">Remove<\/button><\/div><\/div><\/div><\/div><\/div><\/fieldset><div id=\"field_21_67\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><strong>Does your child have any of the following?<\/strong><\/div><fieldset id=\"field_21_68\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Allergies (Foods, Medications, etc.)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_68'>\n\t\t\t<div class='gchoice gchoice_21_68_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='Yes'  id='choice_21_68_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_68_0' id='label_21_68_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_68_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_68' type='radio' value='No'  id='choice_21_68_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_68_1' id='label_21_68_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_80\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_80'><span class='gform-field-label__text'>Allergy Details<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_80' id='input_21_80' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_69\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Does child have an Epi Pen \/ Antishistmane?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_69'>\n\t\t\t<div class='gchoice gchoice_21_69_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='Yes'  id='choice_21_69_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_69_0' id='label_21_69_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_69_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_69' type='radio' value='No'  id='choice_21_69_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_69_1' id='label_21_69_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_81\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_81'><span class='gform-field-label__text'>Epi Pen \/ Antihistamine Details<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_81' id='input_21_81' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_70\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Asthma<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_70'>\n\t\t\t<div class='gchoice gchoice_21_70_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_70' type='radio' value='Yes'  id='choice_21_70_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_70_0' id='label_21_70_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_70_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_70' type='radio' value='No'  id='choice_21_70_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_70_1' id='label_21_70_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_82\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_82'><span class='gform-field-label__text'>Asthma Details<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_82' id='input_21_82' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_71\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Is a &quot;rescue&quot; inhaler needed in the class?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_71'>\n\t\t\t<div class='gchoice gchoice_21_71_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='Yes'  id='choice_21_71_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_71_0' id='label_21_71_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_71_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_71' type='radio' value='No'  id='choice_21_71_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_71_1' id='label_21_71_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_83\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_83'><span class='gform-field-label__text'>Inhaler Details<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_83' id='input_21_83' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_72\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>G-tube<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_72'>\n\t\t\t<div class='gchoice gchoice_21_72_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='Yes'  id='choice_21_72_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_72_0' id='label_21_72_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_72_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_72' type='radio' value='No'  id='choice_21_72_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_72_1' id='label_21_72_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_84\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_84'><span class='gform-field-label__text'>G-tube Details<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_84' id='input_21_84' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_186\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Chronic condition \/ medical diagnosis<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_186'>\n\t\t\t<div class='gchoice gchoice_21_186_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_186' type='radio' value='Yes'  id='choice_21_186_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_186_0' id='label_21_186_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_186_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_186' type='radio' value='No'  id='choice_21_186_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_186_1' id='label_21_186_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_187\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_187'><span class='gform-field-label__text'>Condition \/ Diagonisis Details<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_187' id='input_21_187' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_73\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Diabetes<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_73'>\n\t\t\t<div class='gchoice gchoice_21_73_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='Yes'  id='choice_21_73_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_73_0' id='label_21_73_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_73_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_73' type='radio' value='No'  id='choice_21_73_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_73_1' id='label_21_73_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_85\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_85'><span class='gform-field-label__text'>Diabetes Details<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_85' id='input_21_85' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_74\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Heart or circulatory disorder<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_74'>\n\t\t\t<div class='gchoice gchoice_21_74_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='Yes'  id='choice_21_74_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_74_0' id='label_21_74_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_74_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_74' type='radio' value='No'  id='choice_21_74_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_74_1' id='label_21_74_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_86\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_86'><span class='gform-field-label__text'>Heart Details<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_86' id='input_21_86' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_75\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Musculoskeletal\/mobility disorder<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_75'>\n\t\t\t<div class='gchoice gchoice_21_75_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='Yes'  id='choice_21_75_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_75_0' id='label_21_75_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_75_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_75' type='radio' value='No'  id='choice_21_75_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_75_1' id='label_21_75_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_87\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_87'><span class='gform-field-label__text'>Musculoskeletal\/Mobility Details<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_87' id='input_21_87' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_76\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Seizures<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_76'>\n\t\t\t<div class='gchoice gchoice_21_76_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='Yes'  id='choice_21_76_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_76_0' id='label_21_76_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_76_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_76' type='radio' value='No'  id='choice_21_76_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_76_1' id='label_21_76_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_88\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_88'><span class='gform-field-label__text'>Seizures Details (list type &amp; daily medications)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_88' id='input_21_88' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_77\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Visual\/hearing impairment<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_77'>\n\t\t\t<div class='gchoice gchoice_21_77_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='Yes'  id='choice_21_77_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_77_0' id='label_21_77_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_77_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_77' type='radio' value='No'  id='choice_21_77_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_77_1' id='label_21_77_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_89\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_89'><span class='gform-field-label__text'>Visual\/Hearing Details<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_89' id='input_21_89' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_78\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Other health problems<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_78'>\n\t\t\t<div class='gchoice gchoice_21_78_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='Yes'  id='choice_21_78_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_78_0' id='label_21_78_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_78_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_78' type='radio' value='No'  id='choice_21_78_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_78_1' id='label_21_78_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_90\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_90'><span class='gform-field-label__text'>Other Details<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_90' id='input_21_90' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_79\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio gf_list_inline gf_left_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Daily Medications<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_79'>\n\t\t\t<div class='gchoice gchoice_21_79_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_79' type='radio' value='Yes'  id='choice_21_79_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_79_0' id='label_21_79_0' class='gform-field-label gform-field-label--type-inline'>Yes<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_79_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_79' type='radio' value='No'  id='choice_21_79_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_79_1' id='label_21_79_1' class='gform-field-label gform-field-label--type-inline'>No<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_91\" class=\"gfield gfield--type-text gfield--input-type-text gf_right_half gfield--width-half gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_21_91'><span class='gform-field-label__text'>Medications Details<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_91' id='input_21_91' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/div><fieldset id=\"field_21_94\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden gfield--choice-align-vertical\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>If you have marked &quot;yes&quot; on any of the above medical questions, it is your responsibility to contact the preschool nurse to discuss your child&#039;s health care needs before your child begins preschool.  You must also notify your child&#039;s teacher of health concerns.<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_94'><div class='gchoice gchoice_21_94_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_94.1' type='checkbox'  value='X'  id='choice_21_94_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_94_1' id='label_21_94_1' class='gform-field-label gform-field-label--type-inline'>Please check to indicate you have read the above statement.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_92\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden gfield--choice-align-vertical\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Vision and hearing screening is part of your child&#039;s preschool curriculum.  If you do not want your child screened, please notify us at 385.646.4672. (Si usted no quiere que su hijo sea examinado)<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_92'><div class='gchoice gchoice_21_92_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_92.1' type='checkbox'  value='X'  id='choice_21_92_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_92_1' id='label_21_92_1' class='gform-field-label gform-field-label--type-inline'>Please check to indicate that you have read the above statement.<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><fieldset id=\"field_21_104\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden gfield--choice-align-vertical\"  ><div class=\"admin-hidden-markup\"><i class=\"gform-icon gform-icon--hidden\" aria-hidden=\"true\" title=\"This field is hidden when viewing the form\"><\/i><span>This field is hidden when viewing the form<\/span><\/div><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>Choose one payment method<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_104'>\n\t\t\t<div class='gchoice gchoice_21_104_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='Automatic credit or debit card. Payment is charged on the 20th. You must call our office in August to set up payment arrangements.'  id='choice_21_104_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_104_0' id='label_21_104_0' class='gform-field-label gform-field-label--type-inline'>Automatic credit or debit card. Payment is charged on the 20th. You must call our office in August to set up payment arrangements.<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_104_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_104' type='radio' value='Pay each month by calling the office with credit or debit card number.'  id='choice_21_104_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_104_1' id='label_21_104_1' class='gform-field-label gform-field-label--type-inline'>Pay each month by calling the office with credit or debit card number.<\/label>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_105\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><p>Payments are due on the 20th of each month. You may set up automatic payments through the parent portal.<\/p><\/div><div id=\"field_21_106\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><p>You must call our office by 4:00 pm on the 25th of each month in order to avoid a $10 late fee. Our office number is 385.646.4675.<\/p><\/div><div id=\"field_21_109\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_hidden\"  ><p>You must pay <em>in person<\/em> at the Preschool office with <em>exact change only<\/em> and the bottom portion of your invoice. Payments must be made between the hours of 9:00 am and 4:00 pm.<\/p><\/div><fieldset id=\"field_21_146\" class=\"gfield gfield--type-radio gfield--type-choice gfield--input-type-radio field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label' ><span class='gform-field-label__text'>How did you hear about our program?<\/span><\/legend><div class='ginput_container ginput_container_radio'><div class='gfield_radio' id='input_21_146'>\n\t\t\t<div class='gchoice gchoice_21_146_0'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Flyer'  id='choice_21_146_0' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_146_0' id='label_21_146_0' class='gform-field-label gform-field-label--type-inline'>Flyer<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_146_1'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Internet'  id='choice_21_146_1' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_146_1' id='label_21_146_1' class='gform-field-label gform-field-label--type-inline'>Internet<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_146_2'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Returning Student'  id='choice_21_146_2' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_146_2' id='label_21_146_2' class='gform-field-label gform-field-label--type-inline'>Returning Student<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_146_3'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Referred by Someone'  id='choice_21_146_3' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_146_3' id='label_21_146_3' class='gform-field-label gform-field-label--type-inline'>Referred by Someone<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_146_4'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='Elementary School Sign\/Web Page\/Newsletter'  id='choice_21_146_4' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_146_4' id='label_21_146_4' class='gform-field-label gform-field-label--type-inline'>Elementary School Sign\/Web Page\/Newsletter<\/label>\n\t\t\t<\/div>\n\t\t\t<div class='gchoice gchoice_21_146_5'>\n\t\t\t\t\t<input class='gfield-choice-input' name='input_146' type='radio' value='gf_other_choice'  id='choice_21_146_5' onchange='gformToggleRadioOther( this )'    \/>\n\t\t\t\t\t<label for='choice_21_146_5' id='label_21_146_5' class='gform-field-label gform-field-label--type-inline'>Other<\/label><br \/><input id='input_21_146_other' class='gchoice_other_control' name='input_146_other' type='text' value='Other' aria-label='Other Choice, please specify'  disabled='disabled' \/>\n\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_324\" class=\"gfield gfield--type-section gfield--input-type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h3 class=\"gsection_title\">Attestation<\/h3><\/div><fieldset id=\"field_21_302\" class=\"gfield gfield--type-checkbox gfield--type-choice gfield--input-type-checkbox gfield--width-full gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible gfield--choice-align-vertical\"  ><legend class='gfield_label gform-field-label gfield_label_before_complex' ><span class='gform-field-label__text'>Is all information contained in this application is true and accurate to the best of your knowledge?<\/span><span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/legend><div class='ginput_container ginput_container_checkbox'><div class='gfield_checkbox ' id='input_21_302'><div class='gchoice gchoice_21_302_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_302.1' type='checkbox'  value='Yes, the information is true'  id='choice_21_302_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_21_302_1' id='label_21_302_1' class='gform-field-label gform-field-label--type-inline'>Yes, the information is true<\/label>\n\t\t\t\t\t\t\t<\/div><\/div><\/div><\/fieldset><div id=\"field_21_126\" class=\"gfield gfield--type-html gfield--input-type-html gfield_html gfield_html_formatted gfield_no_follows_desc field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><p>After clicking the &#8216;Submit&#8217; button below, please wait until you see a confirmation page. 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     }    } );} );\n<\/script>\n<\/div><\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-gsd-hero-banner hero-banner p-1 p-lg-3\" style=\"width:100vw;margin-left:calc(50% - 50vw);margin-right:calc(50% - 50vw);background-color:#00467f;padding-top:40px;padding-right:20px;padding-bottom:40px;padding-left:20px\">\n<div class=\"wp-block-columns is-layout-flex wp-container-core-columns-is-layout-8f761849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\" style=\"flex-basis:1320px\">\n<div class=\"wp-block-columns mb-0 is-layout-flex wp-container-core-columns-is-layout-8f761849 wp-block-columns-is-layout-flex\">\n<div class=\"wp-block-column d-flex flex-column justify-content-center is-layout-flow wp-block-column-is-layout-flow\">\n<h2 class=\"wp-block-heading mt-0 mb-3 text-center text-md-start has-white-color has-text-color has-link-color wp-elements-2\">Contact Preschool Services<\/h2>\n\n\n\n<div class=\"wp-block-group has-white-color has-text-color has-link-color wp-elements-3 is-content-justification-center is-layout-flex wp-container-core-group-is-layout-de391324 wp-block-group-is-layout-flex\">\n<p class=\"wp-block-gsdsc-icon px-3\" style=\"margin-bottom:0px;color:#ffffff\"><span class=\"icon\" style=\"margin-right:6px\"><i class=\"far fa-map-marker\" style=\"color:#ffffff\" aria-hidden=\"true\"><\/i><\/span><span style=\"display:inline-block\">2500 S State St, Salt Lake City UT&nbsp; 84115<\/span><\/p>\n\n\n\n<p class=\"wp-block-gsdsc-icon px-3\" style=\"margin-bottom:0px;color:#ffffff\"><span class=\"icon\" style=\"margin-right:6px\"><i class=\"far fa-envelope\" style=\"color:#ffffff\" aria-hidden=\"true\"><\/i><\/span><span style=\"display:inline-block\"><a href=\"mailto:preschool@graniteschools.org\">preschool@graniteschools.org<\/a><\/span><\/p>\n\n\n\n<p class=\"wp-block-gsdsc-icon px-3\" style=\"margin-bottom:0px;color:#ffffff\"><span class=\"icon\" style=\"margin-right:6px\"><i class=\"far fa-phone\" style=\"color:#ffffff\" aria-hidden=\"true\"><\/i><\/span><span style=\"display:inline-block\"><a href=\"tel:3856464672\">385-646-4672<\/a><\/span><\/p>\n\n\n\n<p class=\"wp-block-gsdsc-icon px-3\" style=\"margin-bottom:0px;color:#ffffff\"><span class=\"icon\" style=\"margin-right:6px\"><i class=\"far fa-fax\" style=\"color:#ffffff\" aria-hidden=\"true\"><\/i><\/span><span style=\"display:inline-block\">385-646-4671<\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><\/div>\n<\/div>\n<\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"<p>If your child is CURRENTLY enrolled in one of our preschools: Complete the registration form below. Birth certificates and immunization records are NOT required for returning students; however, these items are required: If your child is NEW to our program: Complete the registration form below and submit the applicable supporting documents and pay the registration [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"templates\/template_full_width_no_sidebar.php","meta":{"inline_featured_image":false,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","_gsd_hide_title":true,"footnotes":"","_members_access_role":[],"_members_access_error":""},"class_list":["post-2143","page","type-page","status-publish","entry"],"featured_image_src":null,"featured_image_src_square":null,"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/www.graniteschools.org\/preschool\/wp-json\/wp\/v2\/pages\/2143","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.graniteschools.org\/preschool\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.graniteschools.org\/preschool\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.graniteschools.org\/preschool\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.graniteschools.org\/preschool\/wp-json\/wp\/v2\/comments?post=2143"}],"version-history":[{"count":10,"href":"https:\/\/www.graniteschools.org\/preschool\/wp-json\/wp\/v2\/pages\/2143\/revisions"}],"predecessor-version":[{"id":2282,"href":"https:\/\/www.graniteschools.org\/preschool\/wp-json\/wp\/v2\/pages\/2143\/revisions\/2282"}],"wp:attachment":[{"href":"https:\/\/www.graniteschools.org\/preschool\/wp-json\/wp\/v2\/media?parent=2143"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}