Child's Name (required)
Parent's Name (required)
Your Address (required)
City (required)
Phone Number (required)
Child's Age (required)
Child's Grade just completed (required) ---4 yrsKindergarten1st2nd3rd4th5th6th
Shirt Size (required) ---YXSYSYMYLSML
Medical Info (if any)
Emergency Contact(required)
Van Pickup and Drop-off (required) ---yesno
Who will pick up your child each day, if riding van write "van" (required)
Any additional information you would like to provide
May we have permission to photograph your child (required) ---yesno
May we have permission to use your child's photograph for promotion (required) ---yesno