Summer LEAP 2010 Registration Form

Student's Name
Current Teacher
Current Grade Level
Building
W.A. Wettel Elementary
J.D. George Elementary
E.A. McAllister Elementary
Parent/Guardian Name
Home Phone Number
Cell Phone Number
Work Phone Number
Email
Address
City
Zip Code
Emergency Contact (must have transportation)
Relationship to Student
Emergency Contact Phone Number
Medical Alerts
Educational Needs
My child would like to attend, but is unavailable these dates:
Enter the number below to submit your information.
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