Student Name (First & Last)

Parent Name (First & Last)

Parent Email Address

Parent Phone Number

Student T-Shirt Size

Student's Dream Job

Would you like your student included on the birthday list?

• Yes
• No

Please type your home address in the box below for the class birthday list.

How will your student go home on the first day of school?

• Bus Rider
• Car Rider
• Walker (pickup at church)
• Daycare

How will your student go home every day?

• Bus Rider
• Car Rider
• Walker (pickup at church)
• Daycare