Yearbook Club Interest

Name of child to enroll *

First

Last

Grade

Parent or Guardian Name *

First

Last

Parent or Guardian Email *

Parent or Guardian Phone

Child's Details

Dismissal from Yearbook Club

Bus Rider
Parent Pickup / Walker
Campagna
Other

Please select where your child will need to go after Yearbook Club

Other: Dismissal from Yearbook Club

Please describe where your child will need to go after Yearbook club at ~4pm on Wednesdays.

Emergency Contact

Please provide an alternative contact person in case of emergency. Emergency contacts must be over the age of 18 and capable of caring for the child if you are unavailable.

Emergency Contact's Name *

First

Last

Emergency Contact's Phone Number

Emergency Contact's relationship to the child *