TCA Health & Wellness Form for 2020-2021

TCA Health & Wellness Form for 2020-2021
Please complete the information below, and read and sign the Health & Wellness Pledge form provided. If you have any questions about the form you can contact Mrs. Tina Parrish (TParrish@tcajax.org) for the lower division or Dr. Bob Kinder (BKinder@tcajax.org) for the upper division.
Student Information
CHILD 1:
Student's Name: *

First Name Last Name
Grade: *
CHILD 2:
Student's Name:

First Name Last Name
Grade:
CHILD 3:
Student's Name:

First Name Last Name
Grade:
If you have more children, please put their name and grade below:
Parent/Guardian Information
Parent/Guardian's Name *

First Name Last Name
Primary Email *
example@example.com
Primary Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Please read the TCA Health & Wellness Pledge form (click the form) and check the box and sign below to affirm you have read and acknowledge the information provided.
SIGNATURE OF PARENT/GUARDIAN: *

Clear
Thank you for choosing Trinity Christian Academy for your child’s education. We are so happy your family is part of the TCA family.
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