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DND Club Guardian Form
Hello! Please fill out this form so your child can participate in the after-school DND club. Students cannot participate in the club without this form. ~ Ms. Cole
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* Indicates required question
Email
*
Your email
Student Name (first and last)
*
Your answer
Student Grade Level
*
6th
7th
8th
After-school clubs end at 4:00. Will your child be picked up by a parent/guardian, or will they take the late bus?
*
Picked up by parent/guardian
Late bus
Depends on the day
Emergency contact #1 NAME
*
Your answer
Emergency contact #1 RELATION TO STUDENT
*
Your answer
Emergency contact #1 EMAIL
*
Your answer
Emergency contact #1 PHONE NUMBER
*
Your answer
Emergency contact #2 NAME
Your answer
Emergency contact #2 RELATION TO STUDENT
Your answer
Emergency contact #2 EMAIL
Your answer
Emergency contact #2 PHONE NUMBER
Your answer
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