Wildfire Children's Clinic Registrations
* Required
Child's Last Name
*
Your answer
Child's First Name
*
Your answer
Child's Grade in 2019-2020
*
Not yet in Kindergarten
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Guardian's Name
*
Your answer
Guardian's Phone#
*
Your answer
Guardian's Email Address
*
Your answer
Food Allergies
Your answer
I will get my payment to the Wildfires:
*
By mailing it to Angela Dolezal at PO Box 127, Lindsborg, KS 67456.
By bringing it to the dance clinic on July 2nd.
Submit
Never submit passwords through Google Forms.
This form was created inside of Smoky Valley Public Schools.
Report Abuse
Forms