Summer 2020 Registration

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Child(rens) Name

Child(rens) Age

Grade in Spring 2020

Child(rens) Current School

Address

City

Zip Code

Child's Primary Home Phone

Name Of Parent/Guardian #1

Child's Parent/Guardian #1 Cell Phone

Child's Parent/Guardian #1 Work Phone

Child's Parent/Guardian #1 Email

Name Of Parent/Guardian #2 (if any)

Child's Parent/Guardian #2 Cell Phone

Child's Parent/Guardian #2 Work Phone

Child's Parent/Guardian #2 Email

Does your child have any allergies, other than seasonal?

No

Yes

If yes, please list your child's allergies

Please list any additional information you would like to provide

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