4th & 5th Grade Winter Retreat 2018
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Child First Name
Child Last Name
Boy or Girl
Current Grade Level
Emergency Contact Information (List Name, Relationship & Contact Number)
I am sending medication
Send medication in original container, labeled with child's name. Medications will be signed in at check in. Parent signature required.
My child has the following allergy
Friend Request #1
Friend Request #2
Nightime Concerns or Needs
My child may sleep on a top bunk.
Parents, we need your help!
I can Drive AND Stay as a Sponsor
I cannot help at this time
If volunteering to drive, indicate number of seatbelts in car aside from the driver and front passenger seats.
Name of Parent Volunteer
Medical Release Form is REQUIRED. Form is located under Children and Events.
4/6/2018 5:00 PM -
4/7/2018 5:00 PM
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