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Kindergarten Camp Registration 2019
Please complete the form below to register your child in the Kindergarten Camp August 5 & 6, 2018. 9:00 am - 2:00 pm
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School
*
Choose
Crab Orchard
Highland
Hustonville
McKinney
Stanford
Waynesburg
Child's First Name
*
Your answer
Child's Last Name
*
Your answer
Address
Street Address
*
Your answer
City, State, Zip
*
Your answer
Will your child be attending Kindergarten Camp?
*
My child will attend Kindergarten camp and will be riding the bus.
My child will attend Kindergarten Camp and I will transport.
My child will not attend Kindergarten Camp.
Required
If your child is riding a bus --- please enter Bus Pick-Up Location Address below
Your answer
If your child is riding a bus --- Please enter Bus Drop-Off Location Address below
Your answer
Emergency Contact Information:
Name (First & Last):
*
Your answer
Phone #
*
Your answer
Name (First & Last:
Your answer
Phone #
Your answer
Medical Information:
Has your child been diagnosed by a physician or receiving treatment for:
Asthma (needs inhaler or nebulizer)
Diabetes
Heart Problems
Seizures with or without a fever
Other:
List any allergies that your child may have:
Your answer
Are any of these allergies life threatening?
Yes
No
Please describe allergy below:
Your answer
Is your child on any daily medication that will need to be given during the school day?
Yes
No
Clear selection
If yes above, list any medications that your child will need during the school day.
Your answer
Parent's Name:
Your answer
Parent Phone Number:
Your answer
Do you accept text messages?
Yes
No
Clear selection
Submit
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