Escalante 2022
Summer Registration
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Email *
Student's First Name *
Student's Last Name *
Student's Birthdate *
MM
/
DD
/
YYYY
Student is currently in Grade: *
Parent's Full Name *
Phone Number *
Street Address *
City *
State *
Zip Code *
Emergency Contact Number *
Emergency Contact Name *
Emergency Contact Relation *
Math Level Requesting *
Please make sure to speak with the applicant's current math teacher for a proper recommendation.
Schedule *
As a condition to physically accessing any District classroom or building, students shall present proof that they are fully vaccinated against the SARS-CoV-2 virus (COVID-19) unless exempt for medical or religious reasons. *
Required
A copy of your responses will be emailed to the address you provided.
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