Parent or Guardian First Name *

Parent or Guardian Last Name *

Parent or Guardian Phone Number *

E-Mail *

Child First Name *

Child’s Last Name *

Preferred Name ( First Name, Nickname) ?

Please list any indoor/outdoor activities in which this pupil should not participate?

I verify the above information to be correct, and I understand that completion of this form does not guarantee placement in the Baby-sitting event.

0 + 3 = ?Please prove that you are human by solving the equation *