Free Virtual Summer School Registration Form Template

Virtual Summer School Registration Form

Please complete this form to register for our Virtual Summer School.

Parent/Guardian Information

Name

    Email

      Phone Number

        Home Address

          Preferred Contact Method

            • Phone

            • Email

            • Text

            Student Information

            Student Name

              Grade Level

                Date of Birth

                  Learning Preferences/Special Needs

                    Course Preferences

                    Please select the subjects or courses your student(s) are interested in. Course availability may vary based on enrollment.

                      • Math Enrichment

                      • Science Exploration

                      • Reading and Literature

                      • Creative Writing

                      • Art and Design

                      • Coding Basics

                      Technology Access

                      To participate in virtual classes, students will need reliable internet access and a device. Please confirm your setup below:

                      Device Available

                        • Laptop

                        • Tablet

                        • Desktop

                        Internet Connection

                          • High Speed

                          • Moderate

                          • Limited

                          Platform Familiarity

                            • Zoom

                            • Google Classroom

                            • Microsoft Teams

                            Parent Involvement

                            Parental support enhances the virtual learning experience. Let us know if you’d like to assist in any capacity:

                              • Monitoring student progress

                              • Providing feedback on courses

                              • Organizing virtual meet-ups

                              Emergency Contact

                              Name

                                Relation to Student

                                  Phone Number

                                    Upload Supporting Files

                                    Upload any relevant files, such as photos or documents

                                      Additional Information

                                      Please share any other details or questions that may help us make this summer successful for your student:

                                        Parent/Guardian Signature

                                        • By signing below, I consent to my student’s participation in the Virtual Summer School program and agree to adhere to the guidelines provided.

                                        Name:

                                        Date:

                                        Registration Form Templates @ Template.net