Summer School Registration Form 2024
If you have more than 1 student you are signing up, please sign up each student individually. 

Teachers on Campus by 8:15am. Summer school starts at 8:30am. End of day/pick up at 12:00pm.
Aftercare available. 
Dates: June 10th-July 3rd

Contact Mr. A. for questions: alepf@monteriousd.org, 707-865-2266 
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Student First Name & Last Name  *
Student Current Grade *
Student Allergies (write NA if not applicable) *
Parent/Guardian First & Last Name *
Parent/Guardian Phone Number *
Parent/Guardian Email Address *
Emergency Contact 1 (Include Name, Phone, Relation) *
Emergency Contact 2 (Include Name, Phone, Relation)
 *
Attendance: Any long vacations summer school teachers should know about? Please provide dates if available. *
Aftercare: would you like to enroll your student in the aftercare program?  *
Summer School Student/Parent/Guardian Agreement:

- I will try my best.
- I will follow all school rules.

- I will be a safe and responsible student.  I understand that my parent(s)/guardian(s) will be called for immediate pickup if I do not follow the rules and safety protocols.

- I will not leave my class or group area without permission.

- I will use my words and ask a teacher if I need help with a problem.

- I will inform my teacher of any vacations or expected absences.

- I will arrive on time and my parent(s)/guardian(s) will pick me up on time.

- I will use technology appropriately.

I acknowledge and agree to the following rules for my registration and participation in the summer session at Monte Rio School.


 *
Parent/Guardian Permission (Please type your full name): Yes, I give my student permission to attend Monte Rio Summer Learning Academy.  *
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