Camp Emerson 2019
Last Name *
Your answer
First Name *
Your answer
Twin sibling attending Emerson? *
Grade in 2019-20 *
Elementary School/ Previous School *
Your answer
Parent A (Last name, First) *
Your answer
Parent B (Last name, First) *
Your answer
Home Address *
Your answer
Email Address *
Your answer
How many parents will attend the Parent Session? *
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
If your child takes any daily medication or has serious allergic reactions that require medication, please describe here and notify the main office before Camp Emerson. If not, leave blank.
Your answer
Parent Electronic Signature *
Please enter your name below as your electronic signature
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of LAUSD. Report Abuse - Terms of Service