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Rake Up Boise
Please fill this form out completely, even if you have completed these forms previously. It is the best way to give chaperones all of your contact, emergency, and insurance information.
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* Indicates required question
Student First Name
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Your answer
Student Last Name
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Your answer
Grade
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6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Parent Name (Full Name)
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Your answer
Parent (Emergency) Phone Number
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Your answer
Parent Email Address (Please spell carefully!)
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Your answer
2nd Parent or Contact (Full Name)
Your answer
2nd Parent or Contact Phone Number
Your answer
Does your child have any medical concerns or allergies we need to know about? If so, please explain and fill out Medication Form, if necessary.
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Your answer
Health Insurance Company
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Your answer
Primary Name on the Insurance Policy
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Your answer
Policy Number
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Your answer
Group Number
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Your answer
Member ID Number
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Your answer
Please submit the following to the front desk at Sage
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Signed Risk waiver (will be kept on file for the school year)
Copy of Medcation Form (If you're bringing medications)
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