2019 Summer Bridge Registration Form
Welcome Class of 2023!
It is time to sign up for Summer Bridge. Summer Bridge is a four day program to help bridge the transition from middle school to high school. Students participate in both academic and team building activities. It will run August 12th to August 15th, 8:30 a.m. to 12:30 p.m. Transportation is provided for all students in the Kecoughtan school zone and a shuttle service will be provided for those who are out of zone. The registration form is included here. Additional information and updates will be posted on the Kecoughtan webpage or you can contact Patty Lay at play@hampton.k12.va.us.
Email address *
Parent email address (This will be used to confirm registration and provide transportation information) *
Your answer
Student's Last Name *
Your answer
Student's First Name *
Your answer
Date of Birth *
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Sex *
Your answer
Shirt Size *
Street Address or Postal Box *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Telephone Number *
Please note if it is a cell or home phone number.
Your answer
Will your child need transportation? *
Does your child require special accommodations? *
Please answer yes or no. If yes, please explain.
Your answer
Please list your student's level of math entering the 9th grade: Algebra, Geometry, Algebra 2, other *
Your answer
Parent/Guardian Name *
Your answer
Work/Cell Phone Number *
Include AREA code please
Your answer
Emergency Contact Person Name *
Your answer
Emergency Contact Phone *
Your answer
Relation to Student *
Your answer
Will you be attending the optional Principal's chat on Thursday, August 15, at 10:00 a.m.? *
A copy of your responses will be emailed to the address you provided.
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