Online Registration Form for Parents and Guardians for Parent and Child Nights (PAC)

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1. Name of your child

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2. Parent/Guardian Name

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3. Date of Birth (DOB) and Age of your child

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4. Does your child have any allergies? If yes, please specify

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5. Is sibling care needed?

Yes

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6. If so, what is the age and name of the sibling?

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7. Phone Number

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8. Email Address

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9. Home Address

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10. Do you consent to have photoes taken of your child during PAC and potentially posted on Ellsworth Community School Districts social media?

Yes

Online Registration Form for Parents and Guardians for Parent and Child Nights (PAC)

Question Title

* 1. Name of your child

Question Title

* 2. Parent/Guardian Name

Question Title

* 3. Date of Birth (DOB) and Age of your child

Question Title

* 4. Does your child have any allergies? If yes, please specify

Question Title

* 5. Is sibling care needed?

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* 6. If so, what is the age and name of the sibling?

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* 7. Phone Number

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* 8. Email Address

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* 9. Home Address

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* 10. Do you consent to have photoes taken of your child during PAC and potentially posted on Ellsworth Community School Districts social media?

1. Name of your child

2. Parent/Guardian Name

3. Date of Birth (DOB) and Age of your child

4. Does your child have any allergies? If yes, please specify

5. Is sibling care needed?

6. If so, what is the age and name of the sibling?

7. Phone Number

8. Email Address

9. Home Address

10. Do you consent to have photoes taken of your child during PAC and potentially posted on Ellsworth Community School Districts social media?