Annual Student Registration

All students attending 254 should be registered by a parent of guardian. This information will allow us to get to know your student as well as know who to contact in the event of an emergency. This form may be required annually.

If you need to make an adjustment to your student’s information (adding or changing an emergency contact, for example), please email us at contact@the254.org with the desired changes.

Student name

First Name

Last Name

Preferred name

Birthdate

YYYY

Grade

2025-2026 school year

Emergency contact #1 name

First Name

Last Name

Emergency contact #1 relationship to student

Emergency contact #1 phone number

This will be the first number that we contact in the event of an emergency

(###)

###

####

Emergency contact #2 name

First Name

Last Name

Emergency contact #2 relationship to student

Emergency contact #2 phone number

We will contact this number if the first phone number provided does not answer

(###)

###

####

We can't send email to school accounts, so please use another if you'd like updates about the program.

Photos

I understand photos of student activities may appear in social media or on our website.

Social Media

Do you follow us on Facebook and/or Instagram for updates?

Code of Conduct

I have reviewed the code of conduct

Allergies

Additional student notes, if applicable