Kick Back Interest Form

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Kick Back Interest Form

This form is for FIVE (Virtual) students only! Students who are receiving instruction in person do NOT need to complete this interest form.

* Indicates required question

Email *

Your email

First Name *

Your answer

Last Name *

Your answer

Are you planning to attend the Kick Back? *

Yes

No

I understand that this Kick Back celebration will take place during my FIVE lunch period and I must leave campus immediately after my scheduled time. *

Yes

No

Student Signature *

Your answer

Parent/Guardian Signature *

Your answer

Submit

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This form was created inside of Lexington/Richland School Dist. 5. Report Abuse