Reaching Out to the Community (3rd-5th Grades)
Incoming 3rd Graders - Exiting 5th Graders
Monday, July 9 - Friday, July 13
8 AM - 5 PM (Program run time 9 AM - 4 PM)
Student Name (Please share the name your child prefers to use.)
Your answer
Grade for 2018-19 School Year
Parent/Guardian Name(s)
Your answer
Parent/Guardian Phone #
Your answer
Parent/Guardian Email
Your answer
Student's Mailing Address
Your answer
Student's T-Shirt Size
Does your child have any special physical or medical circumstances/needs of which we should be aware? (conditions, seasonal and/or food allergies, etc.)
Your answer
Is there anything we should know to help us offer your child the most positive and productive experience possible? (i.e. special learning needs, school accommodations, etc.)
Your answer
Do we have your permission to photograph or video tape your child?
Do we have your permission to share your child's image or voice publicly on the following formats (please check all that apply):
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