Dailey Elementary Summer School Registration 2023
TO REGISTER, PLEASE COMPLETE THE FOLLOWING FORM.  We will contact parents/guardians regarding placement status. REGISTRATION SPACE AVAILABLE TO SUBMIT UP TO THREE SCHOLARS PER FORM. If signing up more than three scholars PLEASE fill another form out for the remainder.  

There WILL BE another form to fill for 21st Century. It will be sent home with the student once you have filled this form out. If your student has already attended 21st Century programs this school year, your forms are still on file.

Registration deadline: Friday, June 6, 2023

Summer school runs from June 26 to Aug 3, 2023. It is Monday - Thursday at Dailey Elementary from 8:15 AM to 1:30 PM. Buses will be provided. Breakfast will be served from 8:15AM to 8:30AM and lunch will be provided.
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Parent/Guardian First and Last name *
Relationship to Student(s)
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Parent or Guardian's CURRENT HOME ADDRESS  (Street, City and Zip Code)
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Parent or Guardian's PHONE NUMBER
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What is an alternative phone number?
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 Name of the person that the alternative number belongs to.
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Parent or Guardian's EMAIL ADDRESS
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What is your preferred method of contact?
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How will the student(s) be transported to the school?
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Name of Student 1
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Date of Birth for Student 1
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Grade of Student 1
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Does Student 1 have any allergies or asthma? If yes please list all allergies and medications. 
Name of Student 2
Date of Birth for Student 2
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Grade of Student 2
Clear selection
Does Student 2 have any allergies or asthma? If yes please list all allergies and medications. 
Name of Student 3
Date of Birth for Student 3
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DD
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YYYY
Grade of Student 3
Clear selection
Does Student 3 have any allergies or asthma? If yes please list all allergies and medications. 
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