JPMS Homework Club
Registration Form
I am interested in having my child participate in the after school JPMS Homework Club.
Student Name:
Grade:
Date Student Will Begin:
Method of Transportation:
Walk
Activity Bus
Parent Pick-up
Parent/Guardian Name:
Address:
Home Phone:
Cell Phone:
Work Phone:
Any additional information that will assist us in supporting your child:
I give my child,
, permission to attend the JPMS
Homework Club. We have read and understand the club expectations.
Parent/Guardian Signature
Office Use:
Date Received:
Student Signature