Request edit access
Summer 2018 Strength and Conditioning Registration
Hampden Charter School of Science-East will be offering Summer Conditioning and weightlifting on Mondays, Wednesdays, and Fridays from 10 AM-12 PM. Students can meet in the gym and should be prepared with athletic footwear, clothing, and attitude. Questions can be directed to Mr. Trudeau (dtrudeau@hampdencharter.org) or Mr. Jones (rjones@hampdencharter.org).
Your Email Address *
Your answer
Last Name of Student-Athlete *
Your answer
First Name of Student-Athlete *
Your answer
Grade Entering This Fall *
Date of Birth *
MM
/
DD
/
YYYY
Home Address *
Your answer
Name of Parent Registering Student-Athlete *
Your answer
First Emergency Contact Phone Number: Cell, Home and/or Work *
Your answer
First Emergency Contact Relationship w/ Student-Athlete *
Your answer
Second Emergency Contact Phone Number: Cell, Home and/or Work *
Your answer
Second Emergency Contact Relationship w/ Student-Athlete *
Your answer
Best Contact Number to Receive Group Text Message Regarding Summer Lift Program (Can be parent or student-athlete)-INCLUDE AREA CODE IF NOT 413 *
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Hampden Charter School of Science. Report Abuse - Terms of Service