Rec Student Information
All students must have an up to date Rec Student Agreement on file.
Name of Student *
School *
Required
Grade *
Birthday
MM
/
DD
/
YYYY
Home Address *
Email Address (optional)
Name of Student's Parent(s) or Guardian(s) *
Main Parent Contact Phone Number *
Alternate Parent Contact Phone Number
Non-Parental Emergency Contact Name
Main Emergency Contact Phone Number
Alternate Emergency Contact Phone Number
Important Medical Information
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