Student Details and Information
To better assist us in having the most up to date information regarding your child and emergency contacts, please complete this form by no later than Tuesday, November 24, 2020.

BE ADVISED: Students will ONLY be dismissed to the adults listed below. If another adult is to pick up your child, you need to put the adult's name in writing and send it to your child's teacher. Photo ID will be required when picking up your child.

If you have more than one child attending our school, you must complete the form for each child.
Email address *
Student Last Name *
Student First Name *
Grade *
Teacher Name *
Student Date of Birth *
MM
/
DD
/
YYYY
Student Gender *
Student's Address (# Street, City, State, Zip Code)
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