Riverview 5th/6th Grade Intramurals

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REGISTRATION FORM (Fall Session 2)

PLEASE PRINT & SIGN THE SIGNATURE PAGE AFTER COMPLETING REGISTRATION FORM

Click Link for Signature Page

Child's Name: *

Parent's Name: *

Home or Cell Phone: *

Emergency Phone: *

Grade: *

5th grade

6th Grade

Homeroom Teacher *

Please tell me how your child will be getting home. *

I will pick my child up no later than 3:30 pm.

I authorize my child to walk home.

My child is a Youth Center member and will go there.

My child will ride home with another parent.

Name of parent taking your child home. *

Phone # of parent taking your child home. *

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