separate registration form for each child
(there is a link back to the registration page when you complete this page and hit "SUBMIT")
Child Last Name:
Child First Name:
Child Date of Birth (mm/dd/yyyy):
What grade will child begin in Fall/2013? (sorry, no pre-school class available)
Please list any known allergies or special needs:
If Child is coming with a daycare please include daycare's name & phone #.
Daycare Address & phone#:
Parent/Guardian and Contact Info:
Parent Last Name:
Parent First Name:
Relationship to Child:
What is the best way to reach you?
Questions? Call 445-7206.