Child's Info

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Child's Info

Please fill out only one form per participating child

Which Program(s) do you wish to involve your child?

Buddy Reading (Begins January 1st)

Mini Classes (Begins October 4th, Mondays and Fridays from 2:30-4:30)

Special Events (Youth cooking class on Thursday October 7th)

Cooking Matters Classes (youth and families, schedule is TBA)

Pantry Classes (youth and families, Wednesdays 2:30-5:30 (time subject to change))

Child's First Name *

Child's Last Name *

What grade are they in? *

Kindergarden

1st

2nd

3rd

4th

5th

6th

7th

8th

9th

10th

11th

12th

What is their primary language? *

English

Spanish

Bilingual

Other:

Gender

Female

Male

Prefer not to say

Other:

Clear selection

Preferred Pronouns

She/Her

He/Him

They/Them

Clear selection

Any Learning Disabilities you would like the staff at IYS to be aware of? *

Any Allergies to food? *

Clear form

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