REGISTRATION CHECKLIST Registrationfor SIBLINGS of a current Leitch or 3rd – 5thgrade Warm Springs student
will be held from January 15 – 23, 2013.
Allother new registrants register beginning on January 24, 2013. For Kindergarten, a child must be 5 years old by November 2ndof the year they will be attending school. Following are ALLthe required documents: 1.REGISTRATIONINFORMATION FORM (Complete) 2.RACE/ETHNICITYFORM (Complete and sign) 3. HOMEOWNER'SSTATEMENT OF RESIDENCYOR RENTER'S STATEMENT OF RESIDENCY
(Complete, sign and submit thedocuments as applicable.) (a)If you are a HOMEOWNER, two of the following must be provided: (must be two different items) > Property tax payment receipt (current) > Utility service contract, statement or payment receipts (must be datedafter October 15th) > Pay stub (must be dated after October 15th) > Correspondence from a government agency or general business mail (mustbe dated after October 15th) (b)If you are a RENTER, two of the following must be provided: (must be two different items) PLEASE NOTE - Landlord MUST sign back ofrenter’s statement of residency form. > Rental property contract, lease or paymentreceipts (current) > Utility service contract, statement or payment receipts (must be datedafter October 15th) > Pay stub (must be dated after October 15th) > Correspondence from a government agency or general business mail (mustbe dated after October 15th) (c)If your current residency is not inthe name of either the parent or legal guardian: >you must call the FUSD Pupil Services Department (510) 659-2534 to make anappointment for
a Declaration of Residency
4. STUDENT’SBIRTH CERTIFICATE, PASSPORT OR BAPTISMAL CERTIFICATE Original must be provided forverification.
5. Parent Identification A parent must be present at the time ofregistration and legal form of id must be shown at the
time of registration. If you are a legal guardian, proof oflegal guardianship must be provided
and the guardian must show a legalform of id. In the case of a caregiver, please callthe FUSD Pupil Services Dept. at
(510) 659-2534 to make anappointment for a Caregiver Form.
6. IMMUNIZATIONS >Immunization card must be presented at time of registration > Immunization requirements If immunizations are not up to date you must provide an appointmentcard. Immunizations must be up to datebefore school starts and a new copy of the immunization record mustbe provided to the front office. Your child may not start school without complete immunizations! 
7. HEALTH HISTORY EXAM (complete top portion only) Kindergarten- A physical needs to be scheduled on or after March 1,2013. If you don’t have the completedexam form by the day you register, you mustbring an appointment verification notice/card. 
1st Grade - Acopy of a physical exam dated after March 1, 2013 or an appointmentverification/notice card must be provided. 2nd Grade - Nothingis required.
8. ORAL HEALTH EXAM A dental examneeds to be completed on or after May 31, 2014. If you don’t have the completed exam form by the day you register, you must bring an appointment verificationnotice/card. 
9.HOME LANGUAGE SURVEY (complete and sign) 10.SPECIAL SERVICES CHECKLIST(complete and sign) 11.NOTICE OF POTENTIAL OVERLOAD FORM(complete and sign) 12.Optional Forms (ifapplicable) ProgressReport from Previous School Copyof last IEP or 504 plan (Ifyou don’t know what these are, it probably does not apply to your child)
INCOMPLETEREGISTRATION PACKETS WILL NOT BE ACCEPTED. Packets will be reviewed forcompletion between the hours of 9:00-12:00 and 1:00 – 3:00 (noexceptions). Once packets are complete, we willschedule an appointment during the applicable week of registration to finalizethe registration. | 
