Please check box below. *

• I have read this above release and am fully familiar with its contents.

Adult's Name *

First

Last

Child's Name *

First

Last

Child's Grade

Child's Name

First

Last

Grade

Child's Name

First

Last

Grade

In the students own words, please describe their story. (Please note that the story may be shortened for space issues, but won't be posted without the student's approval.) *

Comment

Submit