Family Information
Please note that this form allows an email address to be entered ONLY ONCE. This is why you must put each student from your family on this form at one time. If you try to register again the system will not let you use the same email address twice. Please do not re-submit with another email address as you will have two entries and may be charged twice. Questions? Email PTA VP of Membership: Debbie Waldron at Debbiewaldron829@gmail.com
Parent/Guardian #1 Email Address: *
Parent/Guardian #1: *
Parent/Guardian #1 - Phone: *
Parent/Guardian #2 - Name:
Additional Parent - Optional
Student #1 Information
The next questions will be regarding the Canyon Rim students in your family. Please fill out the info for one child and then fill out the info for additional children if applicable. All children in your family attending Canyon Rim should be entered on this form.
Student #1 - Name: *
Student #1 - Birthdate (mm/dd/yyyy): *
If you are selecting the Birthday Book Club for this student please enter the MONTH, DAY and YEAR of their birthdate.
Student #1 - Teacher: *
TK - Coulter
TK - Hendrickson
K - Ricupito
K - Beusan
K/1 - Keith
1 - Webb
1 - Huntley
2 - Rodieck (Berg)
2 - Chanin
2/3 - Clasen
3 - Henderson
3 - Bregder
4 - De La Cruz
4 - Kim
5 - Davidson
5 - Marchbanks
6 - Wright
6 - Nevin
Please select the teacher for Student #1. Teachers are sorted by grade level. Make sure you select the correct teacher or your student will not be linked to the correct class.
Student #1 - Room Parent *
Room Parent
Co-Room Parent
Party or Room Helper
Sorry, I can't help at this time
If you are interested in being the room parent or helping with classroom parties for the teacher listed above please check the boxes below.
Student #1 - Digital Marquee Shout Out - $25 *
Yes, I'd like to order a marquee shout-out for this student
No, thank you
Make your child's birthday extra special with a personalized shout-out on our beautiful new Canyon Rim Digital Marquee in front of the school! Fill out the online order form to pre-order a message for this child. All parents will be emailed a google link to a form where you will enter the shout out message - once payment has been confirmed. All messages are limited to 30 characters and must be approved by the principal prior to posting on our marquee. Shout-outs will run for the week of the student's birthday or the week before or after if the birthday falls on a school holiday. Cost: $25 per student Questions? Email crmarquee@gmail.com
Student #1 - Birthday Book Club - $18 *
Yes, I'd like my child to choose a Birthday Book
No, thank you
Join the Birthday Book Club and honor your child's birthday. In your child's birthday month (summer birthdays also honored) they will be able to select a brand new book that will have their name and the year dedicated on the inside cover! The librarian will celebrate your child by reading their chosen book to their class during library time. Additionally your child's name will be displayed in the school office and on our website and social media for the entire school year! The Birthday Book Club is our library's ONLY SOURCE OF FUNDING and expanding our selection of books! Your participation ensures that our library will be stocked with new books for when our students safely return to campus. Birthday Book Club Fee: $18 - one child | $34 - two children | $49 - three children | $60 - four children
Do you have additional Canyon Rim students to register? *
Yes
No
Student #2 Information
Please fill in the information for the second Canyon Rim student in your family. If there are no additional students you may skip.
Student #2 - Name:
Student #2 - Birthdate (mm/dd/yyyy):
If you are selecting the Birthday Book Club for this student please enter the MONTH, DAY and YEAR of their birthdate.
Student #2 - Teacher:
TK - Coulter
TK - Hendrickson
K - Ricupito
K - Beusan
K/1 - Keith
1 - Webb
1 - Huntley
2 - Rodieck (Berg)
2 - Chanin
2/3 - Clasen
3 - Henderson
3 - Bregder
4 - De La Cruz
4 - Kim
5 - Davidson
5 - Marchbanks
6 - Wright
6 - Nevin
Please select the teacher for Student #2. Teachers are sorted by grade level. Make sure you select the correct teacher or your student will not be linked to the correct class.
Student #2 - Room Parent
Room Parent
Co-Room Parent
Party or Room Helper
Sorry, I can't help at this time
If you are interested in being the room parent or helping with classroom parties for the teacher listed above please check the boxes below.
Student #2 - Digital Marquee Shout Out - $25
Yes, I'd like to order a marquee shout-out for this student
No, thank you
Make your child's birthday extra special with a personalized shout-out on our beautiful new Canyon Rim Digital Marquee in front of the school! Fill out the online order form to pre-order a message for this child. All parents will be emailed a google link to a form where you will enter the shout out message - once payment has been confirmed. All messages are limited to 30 characters and must be approved by the principal prior to posting on our marquee. Shout-outs will run for the week of the student's birthday or the week before or after if the birthday falls on a school holiday. Cost: $25 per student Questions? Email crmarquee@gmail.com
Student #2 - Birthday Book Club - $16
Yes, I'd like my child to choose a Birthday Book
No, thank you
Join the Birthday Book Club and honor your child's birthday. In your child's birthday month (summer birthdays also honored) they will be able to select a brand new book that will have their name and the year dedicated on the inside cover! The librarian will celebrate your child by reading their chosen book to their class during library time. Additionally your child's name will be displayed in the school office and on our website and social media for the entire school year! The Birthday Book Club is our library's ONLY SOURCE OF FUNDING and expanding our selection of books! Your participation ensures that our library will be stocked with new books for when our students safely return to campus. Birthday Book Club Fee: $18 - one child | $34 - two children | $49 - three children | $60 - four children
Do you have a third Canyon Rim student to register?
Yes
No
Student #3 Information
Please fill in the information for the third Canyon Rim student in your family. If there are no additional students you may skip.
Student #3 - Name:
Student #3 - Birthdate (mm/dd/yyyy):
If you are selecting the Birthday Book Club for this student please enter the MONTH, DAY and YEAR of their birthdate.
Student #3 - Teacher:
TK - Coulter
TK - Hendrickson
K - Ricupito
K - Beusan
K/1 - Keith
1 - Webb
1 - Huntley
2 - Rodieck (Berg)
2 - Chanin
2/3 - Clasen
3 - Henderson
3 - Bregder
4 - De La Cruz
4 - Kim
5 - Davidson
5 - Marchbanks
6 - Wright
6 - Nevin
Please select the teacher for Student #3. Teachers are sorted by grade level. Make sure you select the correct teacher or your student will not be linked to the correct class.
Student #3 - Room Parent
Room Parent
Co-Room Parent
Party or Room Helper
Sorry, I can't help at this time
If you are interested in being the room parent or helping with classroom parties for the teacher listed above please check the boxes below.
Student #3 - Digital Marquee Shout Out - $25
Yes, I'd like to order a marquee shout-out for this student
No, thank you
Make your child's birthday extra special with a personalized shout-out on our beautiful new Canyon Rim Digital Marquee in front of the school! Fill out the online order form to pre-order a message for this child. All parents will be emailed a google link to a form where you will enter the shout out message - once payment has been confirmed. All messages are limited to 30 characters and must be approved by the principal prior to posting on our marquee. Shout-outs will run for the week of the student's birthday or the week before or after if the birthday falls on a school holiday. Cost: $25 per student Questions? Email crmarquee@gmail.com
Student #3 - Birthday Book Club - $15
Yes, I'd like my child to choose a Birthday Book
No, thank you
Join the Birthday Book Club and honor your child's birthday. In your child's birthday month (summer birthdays also honored) they will be able to select a brand new book that will have their name and the year dedicated on the inside cover! The librarian will celebrate your child by reading their chosen book to their class during library time. Additionally your child's name will be displayed in the school office and on our website and social media for the entire school year! The Birthday Book Club is our library's ONLY SOURCE OF FUNDING and expanding our selection of books! Your participation ensures that our library will be stocked with new books for when our students safely return to campus. Birthday Book Club Fee: $18 - one child | $34 - two children | $49 - three children | $60 - four children
Do you have a fourth Canyon Rim student to register?
Yes
No
Student #4 Information
Please fill in the information for the fourth Canyon Rim student in your family. If there are no additional students you may skip. If you have more than four students at Canyon Rim please contact Debbie Waldron at Debbiewaldron829@gmail.com
Student #4 - Name:
Student #4 - Birthdate (mm/dd/yyyy):
If you are selecting the Birthday Book Club for this student please enter the MONTH, DAY and YEAR of their birthdate.
Student #4 - Teacher:
TK - Coulter
TK - Hendrickson
K - Ricupito
K - Beusan
K/1 - Keith
1 - Webb
1 - Huntley
2 - Rodieck (Berg)
2 - Chanin
2/3 - Clasen
3 - Henderson
3 - Bregder
4 - De La Cruz
4 - Kim
5 - Davidson
5 - Marchbanks
6 - Wright
6 - Nevin
Please select the teacher for Student #4. Teachers are sorted by grade level. Make sure you select the correct teacher or your student will not be linked to the correct class.
Student #4 - Room Parent
Room Parent
Co-Room Parent
Party or Room Helper
Sorry, I can't help at this time
If you are interested in being the room parent or helping with classroom parties for the teacher listed above please check the boxes below.
Student #4 - Digital Marquee Shout Out - $25
Yes, I'd like to order a marquee shout-out for this student
No, thank you
Make your child's birthday extra special with a personalized shout-out on our beautiful new Canyon Rim Digital Marquee in front of the school! Fill out the online order form to pre-order a message for this child. All parents will be emailed a google link to a form where you will enter the shout out message - once payment has been confirmed. All messages are limited to 30 characters and must be approved by the principal prior to posting on our marquee. Shout-outs will run for the week of the student's birthday or the week before or after if the birthday falls on a school holiday. Cost: $25 per student Questions? Email crmarquee@gmail.com
Student #4 - Birthday Book Club - $11
Yes, I'd like my child to choose a Birthday Book
No, thank you
Join the Birthday Book Club and honor your child's birthday. In your child's birthday month (summer birthdays also honored) they will be able to select a brand new book that will have their name and the year dedicated on the inside cover! The librarian will celebrate your child by reading their chosen book to their class during library time. Additionally your child's name will be displayed in the school office and on our website and social media for the entire school year! The Birthday Book Club is our library's ONLY SOURCE OF FUNDING and expanding our selection of books! Your participation ensures that our library will be stocked with new books for when our students safely return to campus. Birthday Book Club Fee: $18 - one child | $34 - two children | $49 - three children | $60 - four children
Digital Marquee Shoutout Summary
Please select the # of students you are signing up for a Digital Marquee Shoutout so that the donation will be added to your total.
Total Digital Marquee Shoutout *
No Shoutouts - $0.00
1 Student - $25.00
2 Students - $50.00
3 Students - $75.00
4 Students - $100.00
Birthday Book Club Summary
Please select the # of students you are signing up for Birthday Book Club so that the donation to our library will be added to your total.
Total Birthday Book Club *
No Birthday Book Club - $0.00
1 Student - $18.00
2 Students - $34.00
3 Students - $49.00
4 Students - $60.00
2024/2025 Canyon Rim PTA Membership Opportunities
Become a Canyon Rim PTA Member & Supporter! *
Roadrunner Friend - $25 Includes: 1 PTA Membership - $25.00
Roadrunner Supporter - $50 Includes: 1 PTA Membership. Mention on our Website Sponsor Page - $50.00
Roadrunner Partner $100 Includes: 1 PTA Membership. Mention on our Website Sponsor Page. Social Media Shoutout - $100.00
Roadrunner Advocate "Speedy Recommends"- $150 Includes: 1 PTA Memberships. Mention on our Website Sponsor Page. Social Media Shoutout. Signage at PTA Events - $150.00
Roadrunner Royalty - $250 Includes: 2 PTA Memberships. Mention on our Website Sponsor Page. Social Media Shoutout. Signage at PTA Events. School Marquee Thank You - $250.00
Not at this time - $0.00
It takes a village — literally! Your PTA membership pledge will connect your family, our school and our community to a nationwide network of PTA members, who share resources, opportunities and tips to support your child and all children. We’re all in this together! Joining PTA does not require you to volunteer in any way. All Canyon Rim parents are welcome to attend PTA meetings, regardless if they are PTA members or not. A single PTA Membership fee includes fees that Canyon Rim must pay to the local, state and national PTA for the many services and benefits they provide.
ADDITIONAL PTA Memberships
2024/2025 Canyon Rim PTA Direct Donation Opportunities
PTA Direct Donation *
Bronze Level - $250 Direct Donation - Recognition: Spring Fundraiser Corporate Sponsor, includes signage at Spring Fundraiser - $250.00
Silver Level - $500 Direct Donation - Recognition: Spring Fundraiser Corporate Sponsor, includes signage at Spring Fundraiser. Business featured on an All Sponsors Banner. Website Sponsor Page and Link. Social Media Recognition and Link - $500.00
Gold Level - $1000 Direct Donation - Recognition: Spring Fundraiser Corporate Sponsor, includes signage at Spring Fundraiser. Business featured on an All Sponsors Banner. Website Sponsor Page and Link. Social Media Recognition and Link. Signage at PTA Events. School Marquee Thank You - $1,000.00
Roadrunner Benefactor - $2000 Direct Donation - Recognition: Spring Fundraiser Corporate Sponsor, includes signage at Spring Fundraiser. Business featured on an All Sponsors Banner. Website Sponsor Page and Link. Social Media Recognition and Link. Signage at PTA Events. School Marquee Thank You. Prominent Business Logo on Website. 6' Gate Banner for 24/25 school year advertising your business - $2,000.00
No, thank you - $0.00
Did you know that Canyon Rim depends on its parents and families and their fundraising support to bridge the gap and provide the enhanced educational programs, technology purchases and upgrades, and campus improvements experienced by all of our children? Your support and partnership are critical and support campus activities. Please visit www.canyonrimpta.net to see the many ways your donation helps our school.
Direct Donation - OTHER AMOUNT
Support Level Recognition Opt In/Out *
I would like to remain ANONYMOUS in support level recognition
I'm totally OK with being listed as a supporter
Canyon Rim PTA Volunteer Opportunities
We are now filling our committees for the below PTA sponsored activities. If you would like more information about how you can help with one of these events, please check the boxes below and you will be contacted via email. Thank you!
I'd like to help with:
— Select —
Neon Night
Trunk or Treat
Fall Book Fair
Spring Book Fair
Speedy's Jog-a-Thon
Parents Night Out
Other Events
Press and hold CTRL and then click each item to select more than one.
PTA Required Waiver
California PTA has required that all families sign a waiver to cover all activities and events throughout the school year.
PTA Required Waiver - List all possible participants *
List full names of all family members (STUDENTS, SIBLINGS, PARENTS) who will participate in all PTA sponsored events for the current school year, which will include, but is not limited to the following: CANYON RIM TRUNK OR TREAT, NEON NIGHT, FAMILY FUN NIGHTS, PARENTS NIGHT OUT, BOOK FAIR, LUNCH WITH A LOVED ONE, ETC.
I (we) hereby advise that the below named minor(s) has/have had the following allergies, medicine reactions or unusual physical condition which should be made known to a treating physician or which could limit participation: (If none please write none.) *
PARENT’S APPROVAL, STUDENT, FAMILY, AND PARTICIPANT WAIVER *
I have read PARENT’S APPROVAL, STUDENT, FAMILY, AND PARTICIPANT WAIVER
The undersigned parent or guardian assumes all risks in connection with the family’s participation in any and all of the PTA sponsored activities. I, the undersigned participant, intending to be legally bound, do hereby for myself and heirs, executors, administrators and assigns, forever waive release and discharge the California State PTA, all PTA officers, employees and agents from all liability, claims or demands for any damage, loss or injury to the student, the student’s property, or parent’s property or to myself in connection with participation in these activities, unless caused by the negligence of the PTA. I do hereby certify that to the best of my (our) knowledge and belief said parties are in good health and of sound mind. In case of illness or accident, permission is granted for emergency treatment to be administered. It is further understood and agreed that the undersigned will assume full responsibility for any such action, including payment of costs. I attest and verify that I am physically fit and able to participate in this event and acknowledge that I am aware of the inherent risks in participating in any athletic event.
FINAL WAIVER AGREEMENT - Parent/Guardian Name *
Please sign Parent/Guardian/Participant Name (person responsible for agreeing to waiver)
Final Submission - Total and Payment
Thank you for completing this form and supporting the Canyon Rim PTA and the many fabulous programs it brings to our students each year! All help with volunteering and financial support is greatly appreciated. Please click "submit" below to be directed to Paypal for payment.
Total includes: Parent Info + Student Info (all in same family) + Birthday Book Club + PTA Memberships + Direct Donation. THANK YOU!
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