Apply Online

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Apply Online

Our online application can assist in expediting the collection of information for your child. After submitting your application, you will need to contact the school to schedule an appointment for an interview.

You must submit an application for each student.
For your convenience, you may upload a copy of your child’s birth certificate and immunization records to the application form. You can take a photo of the items with your phone or scan a copy. We recommend doing this before you start the application process so that the form does not time out.
The application process takes approximately 10 minutes to complete.
We will collect your application fee(s) ($25.00 per student) when we conduct your interview.

Application Form

"*" indicates required fields

Step 1 of 9 - Student Information

Student Legal Name*

First Middle Last

Student SSN*

Student's Address*

Street Address City State ZIP Code

Grade Entering*

Age (as of August 1st)*

Sex*

Male

Female

Date of Birth*

Place of Birth*

Education Background*

Returning DCS Student

New Student

Transfer Student from Another School

Transfer Student from Home School

Previous School Name*

Previous School Address*

Street Address City State ZIP Code

Previous School Phone*

Previous School Status*

Passed

Passed Conditionally

Retained

Do you have a pediatrician or family doctor?*

Yes

Doctor's Name*

First Last

Doctor's Phone*

ER Hospital Preference*

Do you have health insurance?*

Yes

Insurance Company*

Policy Number*

Insurance Phone*

Emergency Contact Information

We require a minimum of one emergency contact.

Emergency Contacts*

Name

Phone

Relation to Student

Over the Counter Medication

I give permission for Dayspring School Administration to administer over the counter medication such as Tylenol, Ibuprofen, Benadryl or throat lozenge.

I do not give permission for Dayspring School Administration to administer over the counter medication such as Tylenol, Ibuprofen, Benadryl or throat lozenge.

Emergency Medical Policy*

In the case of emergency illness or accident, the child is given first-aid and the parents are notified. In the event I cannot be reached to make arrangements for emergency medical care at the time of an accident or illness, I authorize Dayspring Christian School to take my child to the doctor or hospital listed. Dayspring Christian School does not assume responsibility for the payment of hospital, doctor or ambulance fees.

Dayspring Christian School does not assume responsibility for the payment of hospital, doctor or ambulance fees.

Medical Treatment Authorization*

It is my understanding that I will be notified in the case of a medical emergency involving my child. However, in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event my child is injured or becomes ill. I authorize any one or more of the following persons to make emergency medical care decisions on behalf of my child, if required by law or a health care provider or (any) leader in affiliation by Dayspring.

I understand that the church and school will not be responsible for medical expenses incurred solely on the basis of this authorization. Also, by signing this form, I will not hold Dayspring Church, Dayspring Christian School, Pastors, Elders, Teachers or Youth Leaders liable for any incidents where my child may need medical attention.

Medical Notification*

I agree to notify the church and school in the event of any health changes which would restrict my child's participation in any normal youth or school activities. I also understand that the adult supervisors reserve the right to restrict my child from any activity that they do not feel is within the physical capabilities of my child.

By signing below and submitting this form, I understand that my digital signature is legally binding.

Digital Signature*

Date*

Throughout the school year, students may be highlighted in efforts to promote Dayspring Christian School (DCS) activities and achievements. For example, students may be featured in materials to train teachers and/or increase public awareness of our school through newspapers, radio, TV, newsletters, the web, DVDs, displays, brochures, yearbooks and other types of media.

Please select your preference for media permission for your child.

Media Permission

I give DCS and its employees, representatives and authorized media organizations permission to print, photograph and record my child for use in audio, video, film or any other electronic, digital and printed media.

a. This is with the understanding that neither DCS nor its representatives will reproduce said photograph, interview or likeness for any commercial value or receive monetary gain for use of any reproduction/broadcast of said photograph or likeness. I am also fully aware that I will not receive monetary compensation for my child's participation.

b. I further release and relieve DCS, its Board of Directors, employees and other representatives from any liabilities, known or unknown, arising out of the use of this material. I certify that I have read the Media Consent and Release Liability statement and fully understand its terms and conditions.

Media Non-Permission

I do not give DCS and its employees, representatives and authorized media organizations permission to print, photograph and record my child for use in audio, video, film or any other electronic, digital and printed media.

By signing below and submitting this form, I understand that my digital signature is legally binding.

Digital Signature*

Date*

Middle School Electronic Device/Phone Policy

Those in 6th through 8th grade are not allowed to have cellphones/electronic devices out at any time before or during school (7:30am-2:50pm). Cell phones are only allowed to be used after school hours.

Discipline Procedure:

First Offense - phone confiscated and given a warning
Second Offense - phone confiscated, 1 day of ISS; phone call to parent
Third Offense - phone confiscated, 3 days of ISS; phone call to parent, request made that they no longer bring their phone to school

High School Electronic Device/Phone Policy

Those in 9th through 12th grade are allowed to use their phones/electronic devices before school, on breaks between classes, and during lunch. They are NOT allowed to be used or seen at any time during class periods, unless permission is given by their teacher.

Discipline Procedure:

First Offense - phone confiscated and given a warning
Second Offense - phone confiscated, 1 day of ISS; phone call to parent
Third Offense - phone confiscated, 3 days of ISS; phone call to parent, request made that they no longer bring their phone to school

Policy Agreement*

I have read the DCS Electronic Device/Cell Phone contract and fully understand the rules and regulations regarding usage of these devices during school hours. Disregard for these rules may result in disciplinary actions determined by DCS administration and/or faculty as dictated in the DCS handbook under the Discipline Policies section.

Digital Student Signature*

Date*

Digital Parent/Guardian Signature*

Date*

We consider attendance at Dayspring Christian School a privilege, therefore, Christ-like behavior is the primary responsibility of each student. A student may be asked to leave our school if attitude, behavior, academic effort or self-discipline falls short of our standard.

Code of Conduct:

Honor to God
Honor to Self
Honor to Authority
Honor to Peers
Honor to Property

The above areas are relevant to the general guidelines for enrollment at DCS and can be found on pages 11-15 of the handbook.

Honor Commitment Agreement*

I have read the DCS Honor Commitment, understand what is required of me and will adhere to and honor these rules. Disregard for these rules may result in disciplinary actions determined by DCS administration and/or faculty as dictated in the DCS handbook under the Discipline Policies section.

Digital Student Signature*

Date*

Digital Parent/Legal Guardian Signature*

Date*

State law requires proof of citizenship and immunization records. In this case we require a copy of a birth certificate and immunization records for each student.

If you have a medical release form for immunizations you will need to fax that info from your doctor.

We do have Religious Exemptions Forms available in the school office at your request.

For your convenience, you may upload a copy of your child's birth certificate and immunization records. You may also bring these to our office at a later date if you are unable to upload them now.

Birth Certificate

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.

Immunization Records

Accepted file types: jpg, gif, png, pdf, Max. file size: 64 MB.

Accurate and Complete Information*

I certify that the information I have provided is complete and accurate, including the date and place of birth.

Parent/Guardian Digital Signature*

Date*

Name

This field is for validation purposes and should be left unchanged.

Apply Online

Application Form

Parent/Guardian 1

Parent/Guardian 2

Emergency Contact Information

Middle School Electronic Device/Phone Policy

High School Electronic Device/Phone Policy

Helping Students Achieve Their God Given Destiny