Fill it out online

Admission Agreement

The State of Utah's official enrollment form — child information, parent information, emergency contacts, sign-out authorization, and permissions for emergency medical care and transportation.

Fill out the State of Utah Admission Agreement online. We'll email a copy to you and to Sara — no printing required.

View the official PDF Download a blank copy

Preview of the official form

This is the exact State of Utah form. Filling it out on this page sends Sara the same information.

Child information

Child's full name *Date of birth *

Parent 1

Name *Phone number *Daytime phone numberEmail address *Physical address *

Parent 2 (optional)

NamePhone numberDaytime phone numberEmail addressPhysical address

Emergency contacts & sign-out authorization

Emergency contacts (name and phone, one per line — up to 4 people) *These people may be contacted in an emergency if you can't be reached, and are authorized to sign your child out.

Out-of-area emergency contact

Name *Phone number *

Non-emergency transportation (optional)

Type YES to also give permission for non-emergency transportation (optional)Leave blank to decline. This is optional — you may still enroll without granting this.