BrookCodes Registration
Please complete all parts of this registration form.
Student Information
Last Name *
Your answer
First Name *
Your answer
MCPS Student ID #
If you are not in MCPS, write N/A
Your answer
Current Middle School
Your answer
Gender *
Street Address
Your answer
Town/City
Your answer
State
Your answer
Zip Code
Your answer
Home Phone Number
Your answer
Student Email Address *
Your answer
Anything else you need us to know? (food allergies, special access needs)
Your answer
Do you plan to attend Springbrook for High School? *
Parent Contact Information
Information for at least one parent must be submitted in this application.
Parent/Guardian Name #1 *
Your answer
Parent/Guardian #1 Daytime Phone *
Your answer
Parent/Guardian #1 Email Address *
Your answer
Emergency Contact Name
Your answer
Emergency Contact Daytime Phone
Your answer
Emergency Contact Email Address
Your answer
Submit
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