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Complete the information below for EACH student who will be attending. Our summer school session is May 31st - June 23rd from 8:30a until 1:00p - Monday-Thursday each week.  

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* 1. Student #1 First Name:

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* 2. Student #1 Last Name:

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* 3. Student #1 Current Grade:

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* 4. Student #2 First Name

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* 5. Student #2 Last Name

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* 6. Student #2 Current Grade:

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* 7. Student #3 First Name

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* 8. Student #3 Last Name

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* 9. Student #3 Current Grade:

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* 10. Student #4 First Name

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* 11. Student #4 Last Name

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* 12. Student #4 Current Grade:

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* 13. Parent/Guardian First Name:

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* 14. Parent/Guardian Last Name:

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* 15. Parent/Guardian Cell Number:

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* 16. Parent/Guardian Email Address:

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* 17. Emergency Phone Number

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* 18. Is Transportation Needed?

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* 19. Street Address for Pick Up (if applicable):

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* 20. Street Address for Drop Off (if applicable):

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