Parent's First Names
Parent's Last Name
Address
City	State Zip
Home Phone	( ) -
Work Phone	( ) -
Email
Emergency Contact Name:
Emergency Contact Phone:
I give permission to use photos of my child: Yes No
Child 1: First Name Last Name Birth Date Grade in Fall Gender M F Allergies or other needs
Child 2: First Name Last Name Birth Date Grade in Fall Sex M F Allergies or other needs
Child 3: First Name Last Name Birth Date Grade in Fall Sex M F Allergies or other needs
Child 4: First Name Last Name Birth Date Grade in Fall Sex M F Allergies or other needs
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