Emergency Contact: ________________________________ Phone # (       ) ___________________

Children:                                                Birth Date:                                     Grade as of 9/08:

 1. ______________________________     ____________________________     _______________

 2.  _____________________________      ____________________________     _______________

 3. ______________________________     ____________________________     _______________

Do any of your children have any special needs we should be aware of ?  __________
If yes, please explain on back of form. (food allergies, physical/learning challenges, etc. )

We need MANY VOLUNTEERS to make this program a success. Please join us!  Training and supplies are
provided. Parents and a limited number of students 6th grade and up can volunteer. Nursery service is available
for parent volunteers*.

Parent Volunteer: ____________________________________ Phone # (       ) ______________________
Student Volunteer: ___________________________________ Phone # (       ) ______________________

Please check off volunteer choices (indicate P for parent and S for student volunteer)
_______ Class Teacher for ______ Grade;         _______ Class Aide for ________ Grade;
_______ Crafts Assistant;       _______ Nursery Worker;           _______ Snack Server

* Will you need nursery service? ________.    If yes, what is child's name & age ?
______________________________________________________________________________________