Salem Athletics Halloween 2019
Please fill out this form on behalf of your child (children) if you plan on attending our event! Thank you!

Questions? Contact us our Athletic Department. Brian.Samulski@pccsk12.com
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Parent/Guardian Name *
Parent/Guardian Email *
Parent/Guardian Phone Number *
Child #1 Name *
Child #1 Grade *
Child #2 Name
Child #2 Grade
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Child #3 Name
Child #3 Grade
Clear selection
Child #4 Name
Child #4 Grade
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Note (please indicate if siblings younger than Kindergarten are attending)
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