Oct Book Club Permission: 5th & 6th Grades
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Student's First and Last Name *
Student's Grade and Teacher *
Parent/Guardian gives permission or student to stay for book club on Monday, October 17 from 3:00-4:00.  *
Students will be dismissed at 4:00. Which situation fits your student's need? *
Leave a phone number where a parent/guardian can be reached quickly in case of emergency or pick-up reasons. *
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