Irving School's Nature and Science Club
5th Grade Registration Form

 

EXAMPLE OF A 
5
th
GRADE – FROM SPRING 2006
IRVING SCHOOL NATURE AND SCIENCE CLUB
REGISTRATION FORM

Please return to the Irving School office.

Registration for the Wednesday club is limited to 5th graders at Irving School and is first come, first served.  

Student’s Name:  ___XXXXXXXXXXXXXXXXXXX___

Teacher:__XXXXXXXXXX__ 

Parent/Guardian’s Name:__XXXXXXXXXXXXXXXXX___

Parent’s Daytime Phone:___XXXXXXXXXX___

Email address:____XXXXXXXXXXXXXXXXXXXXXXX____

I give permission for my child, ____XXXXXXXXXXXX___, to participate in the Irving School 5th-Grade Nature and Science Club on Wednesdays, May 17, 24, and 31.  I also give permission for my child to take walking trips around the Irving School grounds, assist with rocket launches, and handle small live animals—all with adult supervision.

Enclosed is _______.  There is a $15 fee for materials payable in cash or by check made payable to Irving PTO.  Financial assistance is available for students eligible for the free or reduced-fee lunch program.

___ My child is eligible for free or reduced lunch, so please waive the Nature and Science Club fee.

_______                ________________________________
Date                        Parent/Guardian Signature

If disability-related accommodations are needed, please contact Eric Gyllenhaal at 708-848-3083 at least one week before the first meeting.

Return to Nature and Science Club Home Page

 

Questions or comments?  Please e-mail Eric at NatureClub@SaltTheSandbox.org

This page was last updated on April 14, 2006.