Child's Information
First Name
*
Last Name
*
School Grade
*
-- None --
2 & 3 year old
PreK 4/5
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Tip: What grade is your child for the 2022-23 school year?
Gender
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Female
Email Address
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Health Information
Please provide any health concerns you believe we should be aware of.
Allergies
*
Special Needs
*
Additional Health Info
Emergency Contact Information
Contact Name
*
Contact Relationship
Contact Phone
*
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