Donation

Test

Please enable JavaScript in your browser to complete this form.

Student Information

Please have a Parent / Adult Responsible for the Student complete the online Registration Form.
Student Name
(Optional)
Which school do you attend?
Which grade are you in?
What hour do you have English class?

Parent(s) / Adult(s) Responsible for Student

Parent Name
2nd Parent Name
(optional)

In Case of Emergency

Additional Emergency Contact
Name

Transportation

Transportation TO the Alden B. Dow Home and Studio
Transportation HOME is the responsibility of the Parent / Adult Responsible for Student.

Please be prompt for pick-up at 4:45 pm at the Alden B. Dow Home and Studio (315 Post Street - (989) 839-2744). For pick-up, please pull into the circular drive.

Consent

Parent / Adult Responsible for Student, please complete this section.
Student may receive emergency medical treatment if necessary.
I give permission to photograph the student and use images for publicity.
Would you like to be contacted to help with the cost of snacks and supplies?
I confirm my student will be picked up from the Alden B. Dow Home and Studio at 4:45 pm by one of the adults listed on this registration form.
  • 315 Post Street, Midland, MI 48640
  • (866) 315-POST | (989) 839-2744
  • info@abdow.org
Recent Posts

© 2021 Alden B. Dow Home & Studio, All Rights Reserved. | Site By DCTree Marketing

0
    0
    Your Cart
    Your cart is emptyReturn to Shop
    Continue Shopping
    Call Now ButtonCall Now