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Dr. Martin Luther King, Jr. High School - 2018 Summer Bridge Program
Registration. Form
Participation *
Last Name of Student *
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First Name of Student *
Your answer
Last Name of Parent / Guardian *
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First Name of Parent / Guardian *
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Street Address *
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City, State, Zip Code *
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Parent / Guardian Email Address *
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Parent / Guardian Contact Number *
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Emergency Contact Name *
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Emergency Contact Number
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I understand that The Summer Bridge Program will take place the week of July 16-19, 2018 from 9am-1pm. Breakfast, lunch and transportation will be provided. For students to receive the maximum benefits of the program, students are expected to attend each day for the complete 4 hours for the duration of the program. I also affirm that the information I submitted on behalf of the student is accurate. *
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