2017-2018 Mazzuchelli Catholic Middle School Healthy Kids Act
Please complete this form by August 23. Both you and your student(s) need to digitally sign the Physical Activity Contract portion of this form and other portions that apply to your student.
Parent/Guardian Name(s) (Last name, First Name(s)) *
Your answer
Mazzuchelli Student Information
Please complete the information for your student at Mazzuchelli.

A form needs to be completed for each student at Mazzuchelli.

Student Last Name *
Your answer
Student First Name *
Your answer
Student Grade *
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