Please provide the following registration information:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Phone
Age
Sex	Male Female

Last grade completed:  Preschool Kindergarden 1st Grade 2nd Grade 3rd Grade 4th Gade 5th Grade 6th Grade

Please provide the following emergency contact information:

Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Day Phone
Evening Phone
E-mail
Relationship
	Father Mother Guardian Other

Enter your child's allergies or medical conditions in the space provided below.