Loop Sports for Kids
Registration Form 2020-2021 School Year
Email address *
Registration (check all that apply) *
Required
Child's First and Last Name (include nickname if applicable) *
Child's School *
Child's Grade *
Teacher's Name and Room Number *
Child's Dismissal Time *
Time
:
Child's Birthday
MM
/
DD
/
YYYY
Child's Home Address include Apartment Number *
Child's Doctor's Name *
Child's Doctor's Phone Number *
Parent A) First and Last Name *
Parent A) Cell Phone Number *
Parent B) First and Last Name
Parent B) Cell Phone Number
Primary Number to call for home drop off and name of person if different from parent *
Is your child allergic to anything?
A copy of your responses will be emailed to the address you provided.
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