Norton Safety Town 2024
Welcome to Norton Safety Town!  We will meet everyday the week of June 3 - 7.  Please call Vicky Wallace @ 330-825-4967 with any questions. We are excited to meet our future Little Panthers!
Sign in to Google to save your progress. Learn more
Email *
Little Panther's First Name *
Little Panther's Last Name *
Address *
City, State, Zip *
Parents' Names *
Home Phone Number
Dad Cell Phone Number
Mom Cell Phone Number
We practice our phone numbers at Safety Town....what number would be the first number you would want your child to call in an emergency?  *
Email (for Safety Town use ONLY) *
T-Shirt Size (Youth Sizes) *
The only "snack" provided for our students is a Flavor-Ice during our popsicle break.  Please make us aware of any other health concerns we need to know about?
Emergency Contact Name (if we can't reach Mom or Dad) *
Emergency Contact Phone Number *
Choice of Session  *

Please sign below giving permission for your child to go on a bus ride (a short trip on the school bus to practice following the rules of getting on and off the bus, crossing the street, and other bus safety rules). This is also permission for your child to spend a day at the Norton Fire Station. The City of Norton, Norton City Schools nor the Norton Safety Town Committee can not be held liable for any  injuries or accidents incurred during said trips which were due to my child’s negligence.

Digital Signature Required

 

 *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms