Author: janet

2013 Theme:
Suess on the Loose

Who? All students entering grades 1-5
What? Free lunch, individual reading with an adult volunteer, educational group activities, daily tickets for prizes
When? 12-1:00 p.m. Mon.-Thurs. from June 3-July 11
Where? At the Troy Rec (Use the Water Street entrance)
Why? Students who eat balanced meals and read consistently over the summer will be better prepared to start school in the fall.
Return form to address below. Act quickly. Enrollment limited to the first 50 students. Waiting list will be formed after that. Students will receive a confirmation letter. For more information, call Janet Larck at 339-1850 or the Troy Rec at 440-9805.
Mail this form to: Susan Thokey, 443 Lincoln Avenue, Troy, Ohio 45373
Student’s Name _______________________________________________________________________
School ________________________________ Teacher ____________Just completed _______ grade.
My child is reading:
___ far below grade level
___ slightly below grade level
___ on grade level
___ above grade level
My child will NOT attend these days (camp, vacation, etc): ____________________________________
Parent or Guardian (Print) ________________________________________________________________
Home address __________________________________________________________________________
Phone ________________________________________________________________________________
Emergency Contact Name and Phone _______________________________________________________
Transportation Instructions (circle): Student has permission to walk / Student will be picked-up.
Photo release: I give the Summer Lunch Buddy program and its cooperating agencies permission to use my child’s photo in communications and advertisements. If photos are posted on Troy Rec web site or Facebook page, no children’s names will be used.
parent signature:______________________________________________________________