MILL Class Information
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Email *
Child Name (first last) *
Birthdate *
MM
/
DD
/
YYYY
Relevant allergies/medical conditions.  (Please list allergies or medical concerns for which student needs special classroom accommodation/awareness.)
Mailing Address *
Parent/Guardian (First Last) Name *
Parent/Guardian Phone *
Parent/Guardian Email *
Additional Parent/Guardian Name
Additional Parent/Guardian Phone
Additional Parent/Guardian Email
Other Caregiver Name (e.g., a nanny or grandparent who would be working in the class)
Other Caregiver Phone
Other Caregiver Email
Emergency Contact Name (Relationship) *
Emergency Contact Email *
Emergency Contact Phone *
Is the child a 2 Day or 4 Day student?
The Monday thru Thursday schedule runs 9:30am to 12:15pm and follows the Mercer Island School District calendar for holidays and weather closures.
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If a 2 day student, which days will this student typically attend?
Select up to two.  All students are welcome to participate in field trips even if they are not scheduled on one of their days.
Will this student participate in Lunch Bunch (Tuesdays)?
Lunch Bunch is an extended day on Tuesday from 12:15pm to 1:45pm which gives students an opportunity to play and have lunch with their friends.  The actual cost of Lunch Bunch is TBD and will depend on enrollment.
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Will this student participate in Explore More (Thursdays)?
Explore More is an extended day on Thursdays from 12:15pm to 2:45pm which gives students an opportunity to work more intensively on art and science projects in a small group setting.  The actual cost of Explore More is TBD and will depend on enrollment.
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