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Student Info. 2023-2024
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Student First & Last Name
*
Your answer
Student's Birthday
*
MM
/
DD
/
YYYY
Parent/Guardian Name
*
Your answer
Primary Phone Number for Parent/Guardian
*
Your answer
Primary Email Address for Parent/Guardian
*
Your answer
Parent/Guardian Relationship to Student
*
Mother
Father
Grandparent
Guardian
Emergency Contact if Parent/Guardian cannot be reached (First and Last Name)
*
Your answer
Emergency Contact Phone Number
*
Your answer
Student Allergies (food/insects) or Medical Concerns
*
Your answer
Student Afternoon Transportation
*
Bus Rider
Front Car Rider
Back Car Rider *Must have sibling in 3rd-5th Grade
YMCA
Walker
Bus Riders Only- Please Indicate which bus your student will ride (ex. W1, daycare, WMS/WHS Shuttle
Your answer
If there are any concerns or additional information that you would like to share regarding your student, please use the space below.
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