AG Day Registration Form:

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Please register by May 13th, 2024!

Event Dates
K-2nd: May 30th
3rd-6th: May 31st

9:00am - 2:00pm

If you have any questions please contact the following:

Tessa Uehling: Phone: 308-352-8659 Email: tessa.uehling@perkinscountyschools.org

Cooper Kroeker: Phone: 308-352-6376 Email: cooper.kroeker@perkinscountyschools.org

Seth Burge: Phone: 308-352-6435 Email: seth.burge@perkinscountyschools.org

Parent/Guardian Email: *

Participant's Name (first and last):
*

Grade in 2024-25 School Year:
*

Kindergarten (Event Date: May 30th)

1st Grade (Event Date: May 30th)

2nd Grade (Event Date: May 30th)

3rd Grade (Event Date: May 31st)

4th Grade (Event Date: May 31st)

5th Grade (Event Date: May 31st)

6th Grade (Event Date: May 31st)

Name of Parent/Guardian (first and last):
*

Parent/Guardian Email:
*

Parent/Guardian Phone Number: *

Allergies:
*

None

Other:

Special Needs/Concerns:
*

None

Other:

How would you like to receive reminders about AG Day?
*

Text

Participants T-shirt Size (please let us know if a smaller size is needed)
*

Youth S

Youth M

Youth L

Adult S

Adult M

Adult L

Other:

By signing your name below you give permission for your child to participate in AG Day.
*

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