St. Theresa Registration Form Tuesday Spanish Club Session Three: January 21st-February 25th 3:00-4:00 p.m. Student Name* First Last Student Grade*Please enter a number from 0 to 10.Parent Name* First Last Parent Email* Emergency Contact 1* First Last Emergency Contact Phone 1*Emergency Contact 2 First Last Emergency Contact Phone 2Student Homeroom Teacher* What Happens at 4:00 PM?*Parent PickupAftercare with Innovation LearningSpecial Interests AllergiesIf your child allergic to nuts or other food items? If so, please explainAny vital information about your childParticipation Rules and Release of Liability* I agree to the Participation Rules and Release of Liability Cost Price: Δ
