UPPER NYACK ELEMENTARY MORNING PROGRAM

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UPPER NYACK ELEMENTARY MORNING PROGRAM

Please complete this registration form if you would like to bring your child to Upper Nyack Elementary BEFORE SCHOOL (between 8:00-8:30am) for early morning supervision. Even if you will only be using this service sporadically, please complete the form.

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STUDENT LAST NAME *

Your answer

STUDENT FIRST NAME *

Your answer

GRADE *

KINDERGARTEN

GRADE 1

GRADE 2

GRADE 3

GRADE 4

GRADE 5

PARENT/GUARDIAN NAME(S) *

Your answer

EMERGENCY CONTACT NUMBER *

Your answer

PARENT/GUARDIAN EMAIL ADDRESS *

Your answer

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