Enrollment Date*
MM slash DD slash YYYY
Student's Full Name*
First Last
Grade*
Home Address*
City*
Zipcode*
Gender*
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County of Residence*
Township of Residence*
Birth Date*
MM slash DD slash YYYY
Age*
Birth City*
Birth State*
Name of Parent(s)/Legal Guardian(s)*
Relationship*
Phone*
Cell*
Name of Parent(s)/Legal Guardian(s)
Relationship
Phone
Cell
Parent/Guardian Email*
Student Email
Cell Phone
Last School Attended*
Have you ever attended a public school?**
- Yes
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If so, when and where?*
Phone Number of School:*
School Address*
City*
State*
Zip*
Do you have an IEP or 504 plan?*
If Yes, please give a brief description of the IEP or Section 504 plan.*
If Yes, please give a brief description of the IEP or Section 504 plan.*
- Yes
- No
Student Signature*
Parent/Guardian Signature*
Date*
MM slash DD slash YYYY
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Our Team

KFDC STAFF

Brian Rajdl

A nature enthusiast, wilderness adventurer, guide and mentor. Brian’s path in life is to teach and mentor students and adults about the diverse wonders of our natural world, opening pathways for others to safely…

Heaven Hawkins

Hello all, I am Heaven Hawkins. I will be the new administrative assistant, please come to me with questions, concerns or a friendly conversation! Being someone who has attended and thrived in…

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