|
1st Child
First
Name Last
Name
|
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|
Program |
|
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Childs
School Grade |
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|
Shirt Size / Pants Size |
|
|
Hat Size
/ Socks Size |
|
|
Car Pool Request Only |
|
|
Medical Conditions
(allergies,
asthma, ect..) |
|
|
Special Needs |
|
| |
|
|
2nd Child
First Name Last Name
|
|
|
Program |
|
|
Childs School Grade |
|
|
Shirt Size
/ Pants Size |
|
|
Hat Size
/ Socks Size |
|
|
Car Pool Request Only |
|
|
Medical Conditions
(allergies,
asthma, ect..) |
|
|
Special Needs |
|
| |
|
|
3rd Child First Name Last Name
|
|
|
Program |
|
|
Childs School Grade |
|
|
Shirt Size
/ Pants Size |
|
|
Hat Size
/ Socks Size |
|
|
Car Pool Request Only |
|
|
Medical Conditions
(allergies,
asthma, ect..) |
|
|
Special Needs |
|
| |
|
|
4th Child First Name Last Name
|
|
|
Program |
|
|
Childs School Grade |
|
|
Shirt Size
/ Pants Size |
|
|
Hat Size
/ Socks Size |
|
|
Car Pool Request Only |
|
|
Medical Conditions
(allergies,
asthma, ect..) |
|
|
Special Needs |
|
| |
|
|
5th Child First Name Last Name
|
|
|
Program |
|
|
Childs School Grade |
|
|
Shirt Size
/ Pants Size |
|
|
Hat Size
/ Socks Size |
|
|
Car Pool Request Only |
|
|
Medical Conditions
(allergies,
asthma, ect..) |
|
|
Special Needs |
|
| |
|
|
6th Child First Name Last Name
|
|
|
Program |
|
|
Childs School Grade |
|
|
Shirt Size
/ Pants Size |
|
|
Hat Size
/ Socks Size |
|
|
Car Pool Request Only |
|
|
Medical Conditions
(allergies,
asthma, ect..) |
|
|
Special Needs |
|
| |
|
|
Electronic Signature (Please Print) |
|
|
Parents Electronic Signature Acceptance of Code Of Conduct
|
|
|
Emergency
Contact |
|
|
Emergency
Phone # |
|
|
Parents Or
Guardians Names |
|
|
|
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Volunteer to
do at least one
Hold Control
Key and Click more than one
Will Turn
Blue When Selected |
|
|
Street Address |
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Address (cont.) |
|
|
City |
|
|
State/Province |
|
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Zip/Postal Code |
|
|
Day Phone |
|
|
Cell Phone |
|
|
Email Address |
|
|
Phone # for
message system |
|
| |
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| |
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