Dodge Ball Registration Form

Join Mr. Farnsworth for an afternoon of Dodge Ball fun and play a variety of dodge ball games. Open to all students in grades 4-8

Tuesdays 3:15-4:30 from September 12-November 1

Student Name:
Your answer
Email address:
Your answer
Parent Name(s)
Your answer
Phone numbers
Include home, work, cell (as appropriate)
Your answer
Emergency Contact
Please list name and phone number of an emergency contact (other than parent)
Your answer
Registration Fee $30 (please send into the office)
Make check payable to "St. Anna School"
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