Information for Child #1 - Enter full name, birthdate, & school grade
List allergy/medical info for 1st child & any other info. we should know
List 1st child's interests/activities (including musical abilities)
No
Yes
Information for Child #2 - Enter child's full name, birthdate, and school grade
List allergy/medical info for 2nd child & any other info. we should know
List 2nd child's interests/activities (including musical abilities)
Information for Child #3: Enter 3rd child's full name, birthdate, and school grade
List allergy/medical info. for 3rd child & any other info. we should know
List 3rd child's interests/activities (including musical abilities)
Mother/Guardian name*
Father/Guardian's name*
Family Mailing Address (include street, city, and zip code); If parents' addresses differ, please list both addresses.*
Preferred Phone Number & Email Address for family*