Child's Full Name *

First Name

Last Name

Date of Birth

MM

DD

YYYY

Gender Identity *

No child will be denied admittance to the school based on religion, gender identity, ethnic or national origin, sexual orientation, or family configuration.

Boy

Girl

Non-binary

Gender-fluid

Legal name of parent or guardian *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Legal name of second parent or guardian

(if applicable)

First Name

Last Name

Address 2

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone 2

(if applicable)

(###)

###

####

Have you visited The Magnolia School? *

Yes

No

If yes, when did you visit?

MM

DD

YYYY