ONLINE STUDENT REGISTRATION PACKET

Grades K-12

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HOW TO REGISTER YOUR STUDENT ONLINE

1. Please review the Registration Guidelines, Requirements and Document Checklist.

2. Print, review and complete all required forms for each student.

3. Gather all required Documents, and prepare them in a digital format.

4. Review the ONLINE Registration Instructions (starting on page 10)

5. Go to http://www.brickschools.org/registration to access the online registration process.

REGISTRATION GUIDELINES:

Age Requirements

In order to be registered for Kindergarten, children must be five years of age on or before October 1 of a

given school year. Only an original Birth Certificate with a raised seal is accepted as proof of age.

Baptismal or hospital certificates are not accepted. There are no exceptions to this state age requirement.

All parents/guardians must follow the steps listed below to register your student.

Notice to Parents:

Some documents require a seal from a NJ State Notary Public. You may take the paperwork to a notary of

your choice.

Registration Forms Transfer Card (provided by the transferring school district)

Registration Affidavit (available on Registration website)

Third Party Residency Form - B (as needed) (available on Registration website)

Third Party Residency Student age 18 or older FormB2 (as needed) (available on Registration website)

Residency Guardianship Form - C (Guardianship) (as needed) (available on Registration website)

Request for Records Form (form 5D on page 5)

Student Health Questionnaire (form 6A on pages 6-7)

Consent to Emergency Student Treatment (form 6B on page 8)

Physical Exam Form (Required for Pre-K and Kindergarten) (form 6C on page 9)

Immunization Form (Required for all Students) (provided by student’s doctor)

Notice to Parents:

Registration Deadline for New Students starting in the fall

If you are registering your child in the district for the first time you must submit your registration before

August 20th. If you do not submit your registration by August 20th, we cannot guarantee your child will be

able to begin school on the first day of school in September.

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REGISTRATION REQUIREMENTS

Only the Natural Parent or Guardian May Register a Student - Photo Id Is Required

I. Proof of Residency (necessary before beginning any registration);

A. Four (4) Proofs of Residency must be presented indicating the student lives in the sending district.

1. Tax bill, Deed, Contract of Sale, Closing or Mortgage Statement; or Lease with address of

property; and

2. Three additional documents which may include financial account information, utility bills, credit card

statements, cell phone bill, cancelled check, employment documents such as a pay check, benefit

statements, automobile or renter's insurance. Digital Driver's License (Acceptable as second proof

only!)

B. In the event the student and parent are residing with a third party, the third party must prove

residency as listed above. A “Third Party Residency Form” (“B” Form) must be completed and

notarized by both the third party and the parent/guardian before the student will be registered. In

addition, one proof of residency for the registering party is required.

C. In the event the student is not residing with the parent/guardian, or does not have a court order

indicating placement, then the registering party must apply for an Affidavit of

Guardianship/Residency Agreement (“C” Form).

II. Health Records (Immunizations): YOU MUST HAVE EXISTING IMMUNIZATION RECORDS

(LISTING OF SHOTS) TO REGISTER.

Completed records are:

DPT (4 DOSES*), POLIO (3 DOSES*), MEASLES (2 DOSES**-MMR PREFERRED: or may

submit laboratory results indicating immunity to Measles, Mumps and Rubella for 2nd MMR dose),

RUBELLA**,

MUMPS (1 DOSE**), HEPATITIS B (3 DOSES), VARICELLA (Or proof of chicken pox)

(*1 dose must be after 4th birthday ~ **Must be given after 1st birthday)

Physical exam must occur within one year of registration date, be in writing and signed by an M.D., D.O. or

C.N.P. The physician must state: This is a well child without restriction; or list all medical restrictions

and/or medications, etc.

Exemptions:

Medical: Provide a valid note from a doctor. This must be renewed yearly.

Religious: Application for religious exemption must be submitted for legal review.

III. Original Birth Certificate with raised seal (Bureau of Vital Statistics).

IV. Student Transfer Card

V. Latest Report Card

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Registration Document Checklist

All documents must be in a digital format as a PDF, or Image file (JPG or BMP). Multi-page documents must be in a native PDF document or scanned to a PDF document. Single page documents can be scanned, or captured

via a tablet or Smart Phone camera, as a PDF or Image file.

If you have a Form B or C Residency Document, it must be uploaded in addition to the documents in 4a and 4b, which must show proof of residency for the person you are residing with. You must also include a copy of the

Photo ID for the person you are residing with. The Form B or C must be signed and notarized.

1. Parent/Guardian’s ID (Driver’s License or valid Photo ID)

2. Custody Documents (if applicable)

3. Student’s Original Birth Certificate

4. Proof of Residency Documents:

a. One of the following Primary Documents: i. Original Deed

ii. Mortgage or Mortgage Statement

iii. Original Lease/Rental Agreement

iv. Real Estate Tax Statement

b. Three of the following Supporting Documents: i. Financial Account Statements

ii. Utility Bills

iii. Credit Card Statements

iv. Cell Phone Bills/Statements

v. A Cancelled Check

vi. Employment Documents – Paycheck or Benefits Statement

vii. Auto or Renter’s Insurance Statement

5. Student Records:

a. Current Report Card

b. IEP Document (if applicable)

c. Transfer Card (if transferring from another school)

d. Authorization for Release of Student Records Form (if transferring from another school)

6. Medical Records:

a. Completed Health Questionnaire Form

b. Consent to Emergency Student Treatment Form

c. Physical Exam Document

d. Immunization Records

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BRICK TOWNSHIP PUBLIC SCHOOLS

[ ] Brick Township High School 346 Chambers Bridge Road, Brick, NJ 08723

[ ] Brick Township Memorial High School 2001 Lanes Mill Road, Brick, NJ 08724

[ ] Lake Riviera Middle School 171 Beaverson Boulevard, Brick, NJ 08723

[ ] Veterans Memorial Middle School 105 Hendrickson Avenue, Brick, NJ 08724

[ ] Drum Point Elementary School 41 Drum Point Road, Brick, NJ 08723

[ ] Emma Havens Young Elementary School 43 Drum Point Road, Brick, NJ 08723

[ ] Herbertsville Elementary School 2282 Lanes Mill Road, Brick, NJ 08724

[ ] Lanes Mill Elementary School 1891 Lanes Mill Road, Brick, NJ 08724

[ ] Midstreams Elementary School 500 Midstreams Road, Brick, NJ 08724

[ ] Osbornville Elementary School 218 Drum Point Road, Brick, NJ 08723

[ ] Veterans Memorial Elementary School 103 Hendrickson Avenue, Brick, NJ 08724

[ ] Warren H. Wolf Elementary School 224 Chambers Bridge Road, Brick, NJ 08723

AUTHORIZATION FOR RELEASE OF STUDENT RECORDS

Name of Student:

Date of Birth: Grade:

The above student has enrolled in the Brick Township School District. Please send the following student information

to the school indicated above as soon as possible:

Health Records (originals if coming from within New Jersey required).

Transcript of Academic Records (including grades to date of withdrawal).

Standardized Test Records (including New Jersey HSPA if applicable).

Special Service Records (may be mailed directly to our Child Study Team).

Discipline Records (if the student has been involved in offenses involving weapons, alcohol or drugs, or willful

affliction of injury to persons or an act of violence against persons and/or property committed on school premises,

at school or school sponsored activity, please forward appropriate disciplinary documentation.)

Previous School:

Address:

Phone/Fax:

I HEREBY GIVE MY PERMISSION FOR RELEASE OF THE ABOVE RECORDS.

Signature of Parent/Guardian:

Signature of Student 18 or older:

FORM-5D

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HEALTH OFFICE/NEW ENTRANT QUESTIONNAIRE

Student’s Name ID# D.O.B.

Birthplace Age Sex Grade

Please check the following questions and explain any “Yes” answer on the space provided.

MEDICATIONS:

Does your child take any daily medications? Yes No

If Yes, please list daily medications and doses:

Will your child require medication given in school? Yes

No

ALLERGIES: Is your child allergic to any of the following:

Medications: Yes No

If Yes, please list:

Seasonal Allergies: Yes No

If Yes, please explain:

Bee Sting/Insect Bites: Yes No

If Yes, list medication needed for allergic reaction:

Food Allergies: Yes No

If Yes, which foods? Type

of Reaction? Type

of medication needed for reaction?

Asthma: Yes No

If Yes, frequency of attacks?

Known triggers?

Current daily asthma medications?

Normal Peak Flow

HEART DISEASE/HEART MURMUR: Yes No

If Yes, any limitations in activity?

Please Note: A doctor’s note is required stating there is no limitation of activity to participate in gym, sports, or recess.

KIDNEY DISEASE: Yes No

If yes, please list: _

DIABETES: Yes No If yes, we will discuss and formulate care plan for the school year.

FORM-6A

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Student’s Name: _______________________________________________________

SEIZURES:

Medications/Limitations:

Date of last seizure: Type of seizure:

If current seizure disorder, we will meet and formulate care plan for the school year.

LYME DISEASE: Yes No

If Yes, date of diagnosis: Current medications/limitations?

GLASSES: Yes No

If Yes, when are they to be worn?

HEARING DIFFICULTIES: Yes No

If Yes, please explain:

FREQUENT EAR INFECTIONS: Yes No

If Yes, approximately how many infections and what age(s)?

FREQUENT STREP INFECTIONS: Yes No

History of any of the following?

HEAD INJURIES: Yes No BROKEN BONES: Yes No HOSPITALIZATIONS: Yes No SURGERIES: Yes No

If you answered Yes to any of the above, please give dates and explain:

Please list any other disabilities, limitations, or health concerns:

Previous School Attended: Phone:

Parent/Guardian Signature: Date:

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BRICK TOWNSHIP PUBLIC SCHOOLS

CONSENT TO EMERGENCY STUDENT TREATMENT

I , parent/legal guardian of the student named below, do hereby CONSENT (in advance) to any emergency treatment and/or hospital care rendered to the student at a Medical Center of Ocean County facility in

the event that any situation should arise during school hours or during any school activities that would require emergency treatment

or care rendered to the named student.

This consent is given at the request of the Brick Township Board of Education and the Medical Center of Ocean County so that

prompt emergency treatment of the student may be rendered. This consent extends to the Hospital and its affiliated physicians,

nurses, employees and administrative officer.

I understand that this consent will be lodged with the school that is attended by the student so that it will be immediately available

for delivery to a Medical Center of Ocean County facility in the event that emergency treatment of the student is required.

I further understand that in the event of the rendering of any emergency treatment to the student by the hospital that the hospital will

promptly communicate with me at the telephone number listed below in order to advise me of the emergency situation and treatment

rendered to the student.

I further understand that any costs incurred as a result of hospital treatment will be my responsibility and not that of the

Brick Township Public School District.

AS TO THE STUDENT: (Name) (Age)

(Street Address – Town – State – Zip Code) (Date of Birth)

ALLERGIES that the hospital and/ or emergency care provide would need to be aware of

FORM-6B

AS TO THE PERSON SIGNING THE CONSENT: ___________________________________________________

(Name)

_______________________ ________________________________________________ _______________________

(Relationship to Student) (Street Address-Town-State-Zip Code) (Phone Number)

___________________________________________________________________ ____________________________

(Signature of Person Giving Consent – Parent/Legal Guardian) (Date)

Copies: School Nurse; Athletic Office

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Required Pre-School & Kindergarten Physical Examination for Pupils Entering KINDERGARTEN

Child’s Name: (Last, First, Middle)

Address: City/State: Phone:

Birth Date: Birth Wt: Male: Female:

Parent’s Name:

CODE: 0 – No Defect 1 – Slight Deviation 2 – Requires Attention

E.N.T. R L

Vision R L Hearing R L Teeth

Heart Lungs Abdomen Hernia

Spine Posture Extremities B.P.

Height Weight

Glands

ILLNESSES:

Chicken Pox Measles German Measles Rheumatic Fever

Mumps Convulsions Diabetes Ear Trouble

Pneumonia Allergies Scarlet Fever

Heart Disease _ T.B. Contact Operations

Recommendations or restrictions concerning this student:

Physician’s Signature: Date of well child physical:

Physician’s Stamp

FORM-6C

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Brick Township Public Schools

REGISTRATION PORTAL INSTRUCTIONS 2019-20 / 2020-21

The registration portal is used to collect all information necessary to register your child to attend school. The entire process is completed online. A registrar will follow up with you, after they review your submission, to resolve any issues and finalize the registration.

Select an alternate language if you want the portal to display in another language Click on the requested image to begin.

. Select an alternate Language here

The following Screen will display. Click the “Add Student “button to begin.

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The screen below will then be displayed on your computer.

Please enter all information using upper and lower case. Choose 2019-20 for the school year if you are registering for this school year. Choose 2020-21 for the school year if you are registering for NEXT school year. Select your School of Attendance. Check the registration website “School Finder” for

assistance with your neighborhood school. Choose the Grade level your child will be attending when they enroll. Enter your child’s legal first name as it appears on the birth certificate. Enter your child’s legal last name as it appears on the birth certificate. Enter any Suffix such as Jr., Sr., II, III, IV, etc.

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Choose your child’s ethnicity. You can choose more than one category. Choose your child’s Gender. Enter your child’s date of birth. Enter your child’s city of birth if they were born in the United States. Enter your child’s state of birth if they were born in the United States. NJ is the first

item in the drop down list. Enter the Country your child was born in. United States is the first item in the

dropdown list. Enter the Birth certificate number if it’s available. Enter Date First Enrolled in US School (if born outside the US). Enter Date of First Entry to US (if born outside the US). Choose the language spoken by your child. English is the first item in the drop

down. Choose the language spoken by family members at home. English is the first item

in the drop down. Select the appropriate option for the Military Connected Indicator. This field

relates to either parent/guardian. Select the Insurance Provider that provides coverage for your child. Leave blank if

your child is not covered by Medical Insurance In the Has Med Insurance field, indicate if your child is covered by Medical Insurance In the Release to NJ Family Care field, indicate if you do or do not consent to release

your information to the NJ Family Care program. Indicate if you are filing a Third-Party Residence form. Indicate whether the student resides with one or both parents. Indicated if the student has a current IEP. Indicate if your student is currently receiving ELL/Bilingual services. If your student is transferring from another school district, enter the district name. List the names of all siblings of the student. Enter NONE if there are no siblings. Click the Save Student button after checking your information. A Confirmation Screen will now be displayed. If you have another child you wish to

enter, click the Add Another Student button and complete the same process for that child.

When you are done entering student Information, click the Advance to Next Screen button to continue.

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You will be asked to enter the Primary Address & Contact Information, including: home address, and information for the first guardian. The mother should be registered as the first guardian unless she does not live with the child. In that case the first guardian should be either the Father, or legal guardian.

Enter the guardian’s house number. Enter the guardian’s street. Do not abbreviate Street, Avenue, and Court etc. Enter any apartment number. Enter guardian’s city. It is defaulted to Brick Township. State is defaulted to NJ. Enter guardian’s zip Code. County is defaulted to Ocean. Enter the guardian’s Prefix i.e. Mr. Mrs., Ms., Miss, Dr. Enter the guardian’s first and last name. Choose the guardian’s relationship to Student. Enter the guardian’s home, work, and cell numbers including cell provider. Enter the guardian’s Primary Email address. This email will be used to set up your

parent access account.

Click Save Primary Contact Information to save the information.

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On the next screen, you will see a summary of the Primary Address & Primary Guardian. Repeat the contact entry process for:

o a second Parent/Guardian; o at least one Emergency Contact; and o Contact Information for your child’s Doctor in the Other Contacts section.

After you have completed the entry of all your contact information, click the Advance to Next Screen button. This will bring you to the Documents page. Please review the guidelines and be sure to submit all required documents. Documents must be in digital format as a PDF, or Image file (JPG or BMP). Scroll down below the document guidelines section to get to the document upload module.

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REQUIRED DOCUMENTS

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Click on the “Upload Doc” button for each document that you have available to submit. This will open a file browser for you to select a file from your device. If you are using a tablet or Smart Phone, with a built-in camera, you can also capture an image of a single-page document to upload. The documents that are marked “Required” must be provided in order for your submission to be complete. If you are transferring your child from another school district, the documents noted as required for Transfers must also be provided. If your child has a current IEP, that document must also be uploaded. After you have completed uploading all the documents, click the Advance to Next Screen button. This will bring you to the Home Language Survey. Click the Begin Survey button to start the survey. There will be about 5 questions to answer.

After you have completed the Home Language Survey, click the Advance to Next Screen button. At this time, you will be given an opportunity to review all the information you have entered. You can make changes or proceed to submit the registration request.

Review all of the information you have entered and make any corrections.

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After you have reviewed all the information, scroll to the bottom of the page to create a logon account and submit your registration.

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Enter your e-mail address and a password to create an account. This is an important step. Creating an account will allow you revisit your submission to make corrections or add additional documents. This will also allow the system to send you an email confirmation of the submission.

A Confirmation Form will be displayed after the submission has been accepted. Please print or save a copy for your records. After you print/save the Confirmation Form, click Logout to end your session.

Please visit the Brick Township Public School District Website / Registration http://www.brickschools.org/Registration Homepage to start the registration process or to find further details on the process. Once you have submitted your Registration:

o You will receive a confirmation email indicating that you have successfully submitted a registration package.

o A Registrar will follow up with you to resolve any issues and finalize your registration.

If you have any questions, or need assistance, please call the Central Registration office at 732-785-3000 X 1067.

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