Child's First Name Child's Last Name Grade Entering Select One K- Kindergarten 1- First Grade 2- Second Grade 3- Third Grade 4- Fourth Grade 5- Fifth Grade 6- Sixth Grade Please describe any allergies or special needs for your child. This information will help us serve your child the best we can. Name of Parent or Guardian Responsible for this child. Contact Number E-mail address. In case of emergency, can we bring child to nearest hospital? Yes No Will your family attend the closing celebration on Friday? Yes No How many people will be coming? Please indicate a number. ?Please indicate a number. Media Release Please indicate where we can post a picture or video your child may be in. Inside Church Bulletin Board Yes No Church Web Page Yes No Church Newsletter "Crossword" Yes No
