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Super Summer Enrollment - May 27-June 26 7:45 am - 2:55 pm (Free Breakfast and Lunch)
Questions? Contact Josh Depoe (417-625-5350) or Chris Bozarth (417-625-5320)
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Student Name
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Date of Birth
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DD
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YYYY
Parent/Guardian Name
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Phone Number
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Address
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Parent's Email
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Incoming Grade
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K
1st
2nd
3rd
4th
5th
Current School
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Cecil Floyd
Jefferson
West Central
Irving
Stapleton
McKinley
Royal Heights
Columbia
Soaring Heights
Eastmorland
Kelsey Norman
Brothers/Sisters Attending Super Summer (Please list all)
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Medical Needs/Medications Taken
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Your answer
How will your child get to and from Super Summer?
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Bus
Car Rider
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