Summer School Admission Form
Summer School Admission Form
Please fill out this form completely to enroll your child in the summer school program.
Student Information
Name
Date of Birth
Address
Grade Level (Entering in Fall)
Parent/Guardian Information
Name
Relationship to Student
Phone number
Emergency Contact Information
Name
Relationship to Student
Phone number
Program Selection
Please select the programs your child will participate in
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Academic Enrichment
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Arts and Crafts
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Sports and Recreation
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STEM Activities
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Medical Information
Does your child have any allergies or medical conditions?
If yes, please specify
Signature
By signing this form, I confirm that the information provided is accurate and agree to the summer school program policies.
Name:
Date:
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