November Read to Me Thursdays

Thursdays at 5:30

November 9, 16, 30, December 7 ($80 total)
Student's Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender*

MaleFemale
Parent/Guardian Information
Name*

First NameLast Name
Cell Number*

Area CodePhone Number
E-mail*
Does the student have any allergies, chronic illness, or medical conditions? If yes, please describe.
Should be Empty:

Thursdays at 5:30