* 1. Student's Name

* 2. Grade Entering

* 3. Gender

* 4. Parent Contact Information (please include phone number and email)

* 5. Emergency Contact Information (please include phone number and email)

* 6. Please list persons who will pick up/drop off your student

* 7. Please list any known food allergies

* 8. Comments (please use this space to let us any additional important information- is your students coming with a friend? Are there any special, emotional or learning needs we an be mindful of?)

T