Information Update 2020-2021

Information Update 2020-2021
Child’s name
Child’s name
Date Format: MM slash DD slash YYYY
Main Address
Street Address City State / Province / Region ZIP / Postal Code
New Address?
- Yes
- No
Home Phone
Parent Name
Email
Work Phone
Cell Phone
Cell Phone Carrier
Parent Name
Email
Work Phone
Cell Phone
Cell Phone Carrier
Siblings
Name Age
Please add my cell phone to the emergency “Text Messaging” system.
- YES
- NO
Please provide information on medication, allergies or other important medical information regarding this child:
Please tell us anything that has occurred in the child’s life this past year of which you feel the school should be informed, i.e. divorce, death in the family, injury, etc.
Please give us any additional information of which you wish your child’s teacher and/or the main office to be aware:
Parent’s Signature
Date
Date Format: MM slash DD slash YYYY

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Name	Age