Halifax Community College - 2019 P.R.I.D.E.Summer STEM CAMP Information Form
Release Waiver & Medical Treatment Form Behavior Management Policy and
Student Information Form Photography/Video Release Form
Email address *
Name of student(s) attending camp.
Your answer
Grade of the student(s) attending camp (must be 6th grade or higher.
Your answer
Birth Date of the student(s) attending camp.
Your answer
Mothers Name:
Your answer
Mothers Cell Phone Number:
Your answer
Fathers Name:
Your answer
Fathers Cell Phone:
Your answer
In the event of an emergency, if unable to contact parent(s) or guardian, please contact:
Name:
Your answer
Cell Phone:
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Halifax Community College. Report Abuse - Terms of Service