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Dillo Dash Registration
Step
1
of
2
50%
Name – Parent/Guardian
First
Last
Email – Parent/Guardian
How many children are you registering?
1
2
3
4
5
6
Name – Participant 1
(Required)
First
Last
Grade – Participant 1
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Other
Please select Pre-K if younger than Kindergarten
Homeroom Teacher – Participant 1
Name – Participant 2
(Required)
First
Last
Grade – Participant 2
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Other
Please select Pre-K if younger than Kindergarten
Homeroom Teacher – Participant 2
Name – Participant 3
(Required)
First
Last
Grade – Participant 3
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Other
Please select Pre-K if younger than Kindergarten
Homeroom Teacher – Participant 3
Name – Participant 4
(Required)
First
Last
Grade – Participant 4
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Other
Please select Pre-K if younger than Kindergarten
Homeroom Teacher – Participant 4
Name – Participant 5
(Required)
First
Last
Grade – Participant 5
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Other
Please select Pre-K if younger than Kindergarten
Homeroom Teacher – Participant 5
Name – Participant 6
(Required)
First
Last
Grade – Participant 6
Pre-K
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
Other
Please select Pre-K if younger than Kindergarten
Homeroom Teacher – Participant 6
Consent
(Required)
I agree to the following:
By checking this box, I waive and release any and all claims I may have against Hill Elementary or any individual, sponsors, or volunteers for any and all injuries that may result directly from my or my child(ren)’s participation in this activity. I certify that I am/my child(ren) is (are) in good physical health and fully able to participate.
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