STUDENT APPLICATION FOR SUMMER SCHOOL STUDENT'S NAME * First Name Last Name HOME ADDRESS EMAIL * PARENT NAME(S) * PARENT * List an email address of one of your parents. FOOD Do you have any food sensitivities or allergies? MEDICAL QUESTION Do you have any allergies? If so, please explain. MEDICAL QUESTION Please list the over-the-counter pain relief that you can take if needed. If you do not know, you can leave this blank. Ibuprofen Acetamenophen Benedryl Cold/Flu Medicine TUMS for stomach releif MESSAGE TO DIRECTOR So glad you can join us!
