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Registration for 4J Summer Bridge 2023 July 31 - August 4
A Program Designed for Incoming 9th Grade Students
Hear about high school from the experts!
Junior and senior students will be at Summer Bridge with answers to your questions. They are ready to share lots of stories and advice about surviving and thriving in high school. By knowing what to expect, you’ll have a head start in high school!
Find your way around your school and know where your classrooms are.
Discover important school resources and how to access them.
Connect with old friends and make new ones.
Learn the key ingredients of high school success from awesome Summer Bridge teachers
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* Indicates required question
Email
*
Your email
Student's FIRST Name
*
Your answer
Student's LAST Name
*
Your answer
Student's 4J Identification Number (if you have one)
Your answer
High School Student Will Be Attending:
*
Churchill High School
Sheldon High School
South Eugene High School
North Eugene High School
Eugene Online Academy
Middle School Attended In 8th Grade:
*
Arts & Technology Academy
Cal Young Middle School
Kelly Middle School
Kennedy Middle School
Madison Middle School
Monroe Middle School
Spencer Butte Middle School
Roosevelt Middle School
Eugene Online Academy
Other:
Student Home Address:
*
Example: 200 N Monroe St., Eugene, OR 97402
Your answer
Parent / Guardian Name (Last Name, First Name):
*
Your answer
Parent/Guardian Email
Your answer
Parent Phone Numbers - Cell, Home, Work
*
Please list all available numbers. Examples: 541-790-7700 (Cell) 541-790-7701 (Home) 541-790-7702 (Work)
Your answer
Emergency Contact (Last Name, First Name):
*
Your answer
Emergency Contact Relationship:
*
Example: Grandmother, Aunt, Family Friend, etc.
Your answer
Emergency Contact Phone
*
Example: 541-790-7700
Your answer
Health Conditions: Please indicate if any of these or other conditions apply to your child.
Asthma (please list more specific information below)
Diabetes (please list more specific information below)
Heart Condition (please list more specific information below)
Hearing Loss (please list more specific information below)
Orthopedic Condition (please list more specific information below)
Mobility Limitation (please list more specific information below)
Severe Bee Sting (please list more specific information below)
Seizures (please list more specific information below)
Severe Food Allergy (list which food or foods below)
Speech Disorder (please list more specific information below)
Other:
Please indicate if your student is supported by
IEP
504
Please provide more specific information on health conditions, including required accommodations.
Your answer
Will the student require prescription medication while attending their Summer Bridge session? If so, please list.
Your answer
Session Request
*
Choose
Morning Session: 8:30 - 11: 30 am
Afternoon Session: 12:30 - 3:30 pm
Either Morning or Afternoon
Student Sweatshirt Size
*
XS
S
M
L
XL
XXL
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