Fall 2019 Journey Registration
Please complete by Thursday, October 24th at 12:00 pm. Please send payment in via check made out to ICS to your child's homeroom teacher. This form can be filled out as 1 per family and 1 check can be sent in per family.
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Email *
Student(s) Name(s) *
Student(s) Grade(s) *
If Kindergarten please indicate KC or KN.
Course Name *
*If more than one child in the family, please click all that apply and clarify for each child in the "Courses for Multiple Children in a Family," question box.
Required
Courses for Multiple Children in a Family
If you chose more than one course above, please clarify which choice is for each child
Class Fee(s) and Check Number *
Medical Conditions and Allergies *
Please list by child if more than one child is registering within a family.
I agree to allow my child(ren) to participate in the above course(s) *
Parent Name *
Parent Phone Number *
Parent Email Address *
Pick Up List for your child(ren) (Name and phone number) *
Emergency Contact Information for your Child(ren) *
Name and Phone Number please.
Parent Name and Date *
By completing this information you agree for your child(ren) to participate in the Journeys program for Fall 2019.
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