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Migrant Summer School Registration
Dry Hollow Elementary School: 1314 E 19th St, The Dalles, OR 97058
June 21 - July 22, 2022
Monday - Friday from 4:30 am - 1:30 pm
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* Indicates required question
Student(s) Last Name, Student(s) First Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Grade
*
kinder
1st
2nd
3rd
4th
5th
6th
Required
Allergies (Food/Medicine)?
*
Your answer
Mother/Guardian - phone number
*
Your answer
Mother/Guardian - address or camp name and cabin number
*
Your answer
Father/guardian - phone number
*
Your answer
Father/guardian - address or camp name and cabin number.
*
Your answer
What school is your child attending in 2021-2022?
*
Your answer
Emergency Contacts Name/Relation to Child/Phone Number
*
Your answer
I give permission for my child(ren) to participate in:
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Transportation to and from school and field trips.
To be photographed/filmed for classroom activities, school newsletter, and magazine article.
Does your child need transportation?
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Yes
No
Is your child in an ELD/ELL program?
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Yes
No
Is your child in special education and have an IEP? If so, please provide a copy of the IEP to summer school.
*
Your answer
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