Name - Davenport Schools

Name: _________________________________________________________
Email: __________________________________________________________
Address: _______________________________________________________
City & Zip: ______________________________________________________
Home Phone: (_____) ____________ Mobile Phone: (_____) ___________
Student’s Name(s): ______________________
______________________
_______________________
______________________
Classroom Teacher(s): ____________________
_____________________
Signature: _________________________________ Date: ______________
1.
2.
3.
4.
Please return this form to one of the following locations:
Mail or drop off to McKinley Elementary: 1716 Kenwood Ave, Davenport IA 52803
Send the form with your student to give to his/her teacher.
Fax the form to McKinley School office—563-445-5977
If you have any questions, please contact Mr. Vincent 563-723-6800
A completed DCSD Volunteer Application must accompany this form.
Padres Vigilantes de Estudiantes Grandiosos o por sus siglas en Ingles - WATCH D.O.G.S le invita a
participara como voluntario para visitar y trabajar en la escuela de su niño en su tiempo libre.
Nombre: _______________________________________________________
Correo Electrónico: ______________________________________________
Domicilio: ______________________________________________________
Ciudad y Código Postal: __________________________________________
Tel. de casa: (_____) _____________ Tel. Celular: (_____) _____________
Nombre del estudiante (s): ________________
______________________
______________________
______________________
Salón de Clases y Nombre de la Maestra (s):
____________________________
__________________________________
Firma: ____________________________________ Fecha: _____________
Complete esta forma y escoja alguna de las siguiente opciones:
1. Envíela por correo o simplemente entréguela en la Escuela Primaria McKinley, localizada
en el 1716 Kenwood Ave, en Davenport IA 52803
2. Puede también enviar la forma con su estudiante para que se la entregue a su maestro.
3. O simplemente envíela por Fax a la oficina de la Escuela McKinley al 563-445-5977
4. Si Ud. tiene alguna pregunta favor de llamar a la Sra. Vincent (Directora de este plantel
escolar) al teléfono 563-723-6800.
Deberá ser entregada con esta solicitud, una forma completa de Voluntariado que puede pedir en las
Oficinas del Distrito Escolar de Davenport.
Traducido por Coordinador de Padre de Familia Hispanos para el Distrito Escolar en Davenport, IA / Translated by Hispanic Cultural Liaison DCSD
3rd Annual Superhero
Fun Run/Walk
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New this year! Eisenhower Eagles
join superhero forces
with McKinley McNificats!
Events:
Run/Walk Day Check-In
1:30 check-in/late pick-up. Late registrations will be accepted until 1:45. T-shirts will not be guaranteed for “day of”
registrations.
Sunday October 16, 2016
Warm-ups to begin 5 minutes prior to first race.
2:00 pm 1/4 & 1 Mile Course; 5K to follow
Entry Fee: $5/person or $20/family
Course:
The 1/4 and 1 mile will be on the Eisenhower playground.
The 5K will utilize the bike path to Duck Creek and back.
Route will be marked. A water station and first aide station
will be available on the route.
Pre-Registration:
$5/person or $20/Eisenhower or McKinley families. Cash or
check made payable to Eisenhower PTA. Pre-registrations
will be guaranteed a race day shirt and will be accepted
through Friday, September 30. **T-shirts are only
guaranteed for registrations submitted by September 30.**
T-Shirt Distribution:
Volunteers will be on hand to distribute race day shirts on
Friday, October 14 at the student’s respective school. Late
registrations will be accepted up to and including race day
but t-shirts cannot be guaranteed.
Name
Awards:
Only the first 5K student finishers (boy and girl) from each
school will be timed. All participants will receive a
certificate.
Pre- & Post-Race:
Warm ups to start 5 minutes prior to first race. There will be
refreshments and fun at Eisenhower after the race for all
families.
Volunteers
We are looking for volunteers to assist with the race.
 I am interested in volunteering.
Name: ______________________________
Phone: (______) _____-_______
My area of interest:
 Check-in
 Post race party
 Finish Line Distribution
 Water/First Aide Station
 T-Shirt sorting (time/date TBD)
Age
T-Shirt Size
For additional entries please fill out another form
Entry Fee
(circle one)
Participant 1
Youth S M L XL
Adult S M L XL 2XL 3XL
Participant 2
Youth S M L XL
Adult S M L XL 2XL 3XL
Participant 3
Youth S M L XL
Adult S M L XL 2XL 3XL
Participant 4
Youth S M L XL
Adult S M L XL 2XL 3XL
 $5.00/person
 $20.00/family
Amt Enclosed:
$____________
Note: For the safety of all participants, animals, skateboards, scooters and skates of any kind are prohibited in this event
Waiver of Liability: By submitting this registration I waive any and all claims for myself and my children participating in this event against Eisenhower & McKinley,
Davenport Community Schools, PTA, sponsors, and organizations connected with the Fun Run/Walk for injury or illness that may directly or indirectly result from our
participation in this event. I attest that I have full knowledge of the risks involved in this event, and am physically fit and sufficiently trained to participate in this event.
I give permission to use any photographs or other recordings of us that are taken during this event.
Signature:
Date:
Parent/Guardian Signature if under 18 years of age
Scholarships available based on need