Loop Sports for Kids
Registration Form 2018-2019 School Year
Registration (check all that apply) *
Required
Child's First and Last Name *
Your answer
Child's School *
Your answer
Child's Grade *
Your answer
Teacher's Name and Room Number *
Your answer
Child's Dismissal Time *
Time
:
Child's Birthday
MM
/
DD
/
YYYY
Child's Home Address *
Your answer
Child's Doctor's Name *
Your answer
Child's Doctor's Phone Number *
Your answer
Parent A) First and Last Name *
Your answer
Parent A) Cell Phone Number *
Your answer
Parent B) First and Last Name
Your answer
Parent B) Cell Phone Number
Your answer
Primary Number to call for home drop off *
Your answer
Primary Email Address for Child's Program Arrangements *
Your answer
Is your child allergic to anything?
Your answer
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