Small Town Times - Page 16

SUMMER SCHOOL REGISTRATION June 14 —July 22, 2016 Please register by June 1, 2016 Student’s Name Parent’s Name Address Phone Please circle your response to the following: Grade Child was in during the 2015—2016 school year. Pre-K K 1 2 3 4 5 6 Emergency Contact Information: Name: Phone: Address: Relationship Doctor: Town My child may be released to the following individuals: My child MAY NOT be released to the following individuals: Please list any special instructions or helpful information about your child: (For example: food allergies, fears, special interests, etc.) We will be working with the Greenhouse for 30 minutes, 3 times per week. Send tennis shoes to school for the 6 weeks that can stay here for the summer. Flip flops will not be allowed. Return to the Litchfield School office or Mrs. Sadler as soon as possible. Classes will be June 14—July 22, 2016 Hours: 8:30—12:00 Monday through Friday School Phone: 308-446-2244 16