Summer School 2020 Enrollment Form
Monday, July 6 to Friday, July 31
From 7:30-3:30 each day!
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Email *
Student Last Name, First Name, Middle Initial   *
Male or Female *
Date of Birth *
Grade Entering as of Fall 2020 *
Home Address *
Current Savannah R3 School *
If your child does NOT currently attend Savannah R3, please list the school and district your child attended during the school year. Please know that if your child has participated in another summer school program already, they will not be able to attend the Savannah summer program.  
Summer School Site your child will attend *
Parent/Guardian #1  First & Last Name *
Parent/Guardian #1  Relationship to student *
Parent/Guardian #1  Primay Cell Phone Number *
Parent/Guardian #1  Work Number
Parent/Guardian #2 First & Last Name
Parent/Guardian #2 Relationship to student
Parent/Guardian #2 Cell Phone Number
Parent/Guardian #2 Work Number
Emergency Contact-other than parent or guardian *
Emergency Contact-Relationship to student *
Emergency Contact-Best Number to contact *
Summer School Dismissal Procedures
NO SCHOOL AGE CHILD CARE FOR THIS JULY SUMMER SCHOOL PROGRAM.  
How is your child getting home from Summer School each day? *
MC/JG Car Riders ONLY-Please list your pick-up number below in other option.  
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Health Form
Does your child have an allergy to anything? *
Is your child currently taking any medication at *
If your child needs to take medication at school please list the medication below.
Please describe below any special health problems or concerns that will need to be known during SS hours. *
Name and phone number of students physician and hospital preference: *
Avanti
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