Child's Name (required)
Child's grade as of May 1, 2017 (required) K123456
Gender (required) MaleFemale
Your Name (required)
Your Email # (required)
Contact Phone Number(required)
Other than you, who may pick your child up (required)
Do we have permission to take your child's' picture and use for publicity (required) YesNo
Medical/Allergy Info, i.e. conditions or medcines taking