Kid’s Day of Service

Child Name:*
Birthdate:*
Grade entering:*
Allergies:
Medical conditions:
Who may pick up the child after the event?*
Child's T-shirt size:*
Parent/Guardian #1 Name:*
Email #1:*
Cell phone #1:*
-
Address #1:*
Parent/Guardian #2 Name:
Email #2:
Cell phone #2:
-
Address #2:
Age 3 - Kindergarten will stay on-site for service projects. Grades 1-5 will travel to off-site projects.
Permission (for 1st-5th graders): I give LCC my permission to transport my child to local service projects on a school bus (please type your name to sign):
Date: