Best phone #:
Emergency Contact #1 - Please list the
name and telephone number(s) of a person that we may contact in case
of an emergency.
Alternate phone (optional):
Emergency Contact #2 (Optional)
Information (**** Please use a separate form for each child.)
Child’s First Name:
Child’s Last Name:
Grade your child will finish in the 17/18 School Year
Food Allergies – Because we serve
refreshments to the children each day, please note any food allergies that
your child has so we may be aware of them.
Medical – Please list any physical and/or
medical conditions that we should know.
Does your child have any recent injuries