Vacation application packet

Fill out the form below and click Submit application, or download the blank PDF and return it in person or upload it here.

Blank packet (print and fill by hand)

Download blank PDF

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Upload completed PDF

Already filled out the packet offline? Send it here.

Fields match the paper vacation packet. * = required for online submit.

Student information

First name *

Last name *

Date of birth *

Gender

M F

Address

City

State

ZIP

Grade entering in fall

Name of current school

Home phone

Siblings (age)

Current student?

Yes No

If no, who do we thank for referring you?

Parent / Guardian #1

Home phone

Mobile phone

Address

City

State

ZIP

Occupation

Relationship

Email *

Parent / Guardian #2

Home phone

Mobile phone

Address

City

State

ZIP

Occupation

Relationship

Medical insurance

Subscriber’s name

Insurance name

Subscriber’s phone

Group number

Primary care name

Primary care’s number

Allergies / medical conditions

Emergency contact #1

Home phone

Work phone

Address (city, ST ZIP)

Emergency contact #2

Home phone

Work phone

Address (city, ST ZIP)

Dates & photography

Camp / session dates requested

Parent/guardian (print full name)

Child’s name

Photo use for website / advertising

Grant permission Deny permission

Parent/guardian signature (type full name)

Date

Policy acknowledgment

By signing below you acknowledge the SET School policies included in the packet (grades 1–8, communication, weather, snacks, medical, conduct, technology, pickup).

Parent/guardian signature (type full name)

Date

At least one parent/guardian email is required. A PDF copy downloads when you submit.