Spend-A-Day Registration Form

*Denotes Required Field * Title

Student Information:

* Student Name:

* Gender:

* Current Grade:

Current School:

Medical/Learning Needs:

Student Interests/Hobbies:

Do you know a student at RCS that you would want to be partnered with for the day?

If so, who?

* �Spend-A-Day� Date Request:

Lunch options:

Parent/Guardian Information:

* Parent/Guardian Name:

* Parent/Guardian Phone: ( ) -

* Email:

Church Attending:

* I give my child permission to spend a day at RCS.

Use your finger or mouse to sign in this box.