Student Health Form
The following information must be completed in its entirety In order for any child to attend camp. The questions are divided into 3 parts: personal information, health and wellness. Please be honest and thorough as possible. This information should be completed by September 19th.
What school does your child attend?
Holman -STEM Classroom
Who is your child's teacher?
Student's Name (Last, First)
What is your child's birthdate?
What is your child's height?
What is your child's weight?
What is your address?
Home Phone Number:
Parent Cell phone Number:
Name of an Emergency Contact:
Phone Number for the Emergency Contact:
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