St. Theresa Catholic School Out of School Time Program Participation Form

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Email *

Parent/Guardian Name(s) Nombre(s) de padre/tutor

First and Last name of individuals who are allowed to pick up my child(ren). NOTE: Please contact the Main Office (501-565-3855) and speak to an Administrator if you have a special situation or concerns about who can pick up your child(ren). Nombre y apellido de las personas que pueden recoger a mi(s) hijo(s). NOTA: Comuníquese con la oficina principal (501-565-3855) y hable con un administrador si tiene una situación especial o inquietudes sobre quién puede recoger a su(s) hijo(s).

Emergency Contact Information

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