Kindergarten Camp Registration
Please complete the form below to register your child in the Kindergarten Camp July 31- Aug., 1 2017
School
Child's Full Name
Your answer
Address
Street Address
Your answer
City, State, Zip
Your answer
Will your child be attending Kindergarten Camp?
Required
If your child is riding a bus --- please enter Bus Pick-Up Location Address below
Your answer
If your child is riding a bus --- Please enter Bus Drop-Off Location Address below
Your answer
Emergency Contact Information:
Name:
Your answer
Phone #
Your answer
Name:
Your answer
Phone #
Your answer
Medical Information:
Has your child been diagnosed by a physician or receiving treatment for:
List any allergies that your child may have:
Your answer
Are any of these allergies life threatening?
Please describe allergy below:
Your answer
Is your child on any daily medication that will need to be given during the school day?
Parent's Name:
Your answer
Parent Phone Number:
Your answer
Do you accept text messages?
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