2020 Family Card
Completion of this form will result in your child being assigned a locker. A lock will be provided for the student to use, and must be returned at the end of the school year or at the time of a students withdrawal. Cost of replacement lock is $6.00.
Email address *
Students Last Name *
Your answer
Students First Name *
Your answer
Home Address, Include house number, street and zip code *
Your answer
Parent/Guardian Name *
Your answer
Cell Phone Number *
Your answer
e-mail address *
Your answer
Emergency Contact, name and phone number *
Your answer
Does your child have any unusual or severe physical reaction that would require immediate attention? explain In the case of a serious emergency, your child may have to be taken to the nearest emergency room. Should such an action be necessary, you will be notified as soon as possible and will be responsible for any charges incurred. The school has no funds to meet the bills resulting from care which is sought outside the school setting.
Your answer
signature - by initialing below you are submitting this information as true and accurate *
Your answer
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