Student Record SY 2019-2020
Please only submit this form once per child. If you have more than one child in the school, please fill it out for each child.
Level of child SY 2019-2020 *
Last Name of Child *
Your answer
First Name of Child *
Your answer
Preferred First Name (nickname if applicable)
Your answer
Birthday *
MM
/
DD
/
YYYY
Gender *
Preferred email address (list primary one only) *
Your answer
Preferred mobile number for text messages (list primary one only) *
Your answer
Pedia's Name and Number *
Your answer
Known allergies *
Your answer
Emergency contact information *Name and contact number **You may add more than one. *
Your answer
Authorized Fetchers (Other than Parent/Guardian) *Name and contact number **You may add more than one. *
Your answer
Authorized Cars to pick up child (car and license plate) **You may add more than one. *
Your answer
Will you have a yaya wait for your child during class? *
How will your child be getting to school and picked up? (For gate traffic planning) *
Birthday party plans *
We have 3 class parties each school year (costume day party, Christmas party, and end of the year party). Please check at least 4 boxes with options of food you would be happy to contribute. Only one will be selected for each party. *Notes will be sent home before each party with more details. *
Required
Submit
Never submit passwords through Google Forms.
This form was created inside of The Bridge School. Report Abuse - Terms of Service