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Parent/Guardian Information

Parent/Guardian Name*

Parent/Guardian Email*

Parent/Guardian Phone Number*

Parent/Guardian Signature for Participation*

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Child's Information

Child's Name*

Child's Current Grade*

(Choose One)PreschoolKindergarten1st Grade2nd Grade3rd Grade4th Grade5th Grade6th Grade7th Grade8th Grade9th Grade10th Grade11th Grade

Child's Current School*

Child’s Interests and Hobbies*

Any medical conditions or allergies that we need to be aware of?

Does your child have a specific friend with whom they want to spend the day?

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May Visit Day

(Choose One)Wednesday, May 10thThursday, May 11thFriday, May 12thTuesday, May 16thWednesday, May 17thThursday, May 18thFriday, May 19thWednesday, May 24thThursday, May 25th

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How did you hear about The Prairie School?*

Additional Questions or Comments:

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