Parent Contact Information
Please complete the following information.
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Child's Name (Last, First) *
Child's Date of Birth *
xx-xx-xxxx
Primary Caregiver's name *
Second Caregiver's name-in home (i.e. other parent or stepparent in the home)
Caregiver's name outside the home (i.e. divorced family-other parent out of primary home)
Preferred contact phone number *
(xxx)xxx-xxxx
Who does your child reside with? Check all that apply. *
Required
Preferred contact email address *
What is the best/preferred way to contact you? *
Do you give permission for your child to view PG rated videos for educational and/or reward purposes? *
Does your child have any medical issues you would like me to be aware of? *
Are you interested in helping with class parties? *
Please choose all that apply.
Required
Does your child have any family situations you would like me to be aware of? *
Is your child in any of these programs (as of the end of 4th grade)? *
Required
How will your child get home from school each day? *
What is your child's t-shirt size? Keep in mind, this may be a t-shirt they will wear for a couple of years so I would recommend a larger size than usual. *
Are you already aware of the required Mark Twain nominee reading assignment sent home at the end of 4th grade (or given out when you enrolled if your child is a new student)? *
Since students will be bringing home their Chromebooks this year, does your child have access to WiFi for the purposes of accessing their Google Drive? If not, we will teach students how to update their settings in order to access files offline. *
Any other information you'd like to share? *
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