ATLAS TEAM INFORMATION SHEET
Please complete the following form.
Student Name (First & Last) *
Student's Birthday *
Home address *
Mother/ Guardian's Name (First & Last)
Mother/ Guardian's Phone Number(s)
Mother/ Guardian's Email Address
Father/ Guardian's Name (First & Last)
Father/ Guardian's Phone Number(s)
Father/ Guardian's Email Address
When the child is at home for the evening, who does he/she live with? *
Required
If selected other above, please specify below.
Does your child have any allergies or other medical concerns we need to be aware of? *
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