2023 SUMMER SCHOOL REGISTRATION

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Please complete the form if your child will be in fourth, fifth, or sixth grade for the 2023-2024 school year! We will take three field trips, so there is a $15 activity fee that must be paid by June 5. A permission slip for the field trips will be sent home the first day of summer school.

Email *

CHILD'S NAME *

GRADE FOR THE 2023-2024 SCHOOL YEAR *

FOURTH

FIFTH

SIXTH

PARENT NAME *

PREFERRED PARENT PHONE NUMBER *

OPTIONAL PARENT PHONE NUMBER

TRANSPORTATION *

BUS

PARENT PICK UP

WALKER

IF YOUR CHILD RIDES A BUS: WHAT ADDRESS WILL THEY BE RIDING TO/FROM

CHILD'S CURRENT HOMEROOM TEACHER *

MY CHILD WILL NEED THE FOLLOWNG MEDICAL ATTENTION DURING SUMMER SCHOOL:

DAILY MEDICATION AT SCHOOL

MEDICATION AS NEEDED AT SCHOOL

FOOD ALLERGY

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