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HCS Summer Learning Academy Summer Enrichment 2022
By filling out this form I hereby grant permission for my child to attend the HCS Summer Learning Academy.
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* Indicates required question
Email
*
Your email
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Date of Birth
*
MM
/
DD
/
YYYY
Gender
*
Female
Male
Student Number (10 Digit number that can be located in PowerSchool)
Your answer
SPED Services
*
Yes
No
Medications
Your answer
Allergies
Your answer
Dietary Information
Your answer
Other Health Concerns
Your answer
Legal Guardian's full name
*
Your answer
Legal Guardian's email address
*
Your answer
Legal Guardian's phone number (only numbers no dashes or parentheses)
*
Your answer
Emergency Contact's full name
*
Your answer
Emergency Contact's phone number (only numbers no dashes or parentheses)
*
Your answer
Approved person(s) to check-out student
Your answer
My student's grade in the 2021-2022 SY is:
*
9th Grade
10th Grade
11th Grade
High School attended 2021-2022
*
Columbia
Grissom
Huntsville High
Jemison
Lee
New Century
Are you requesting HCS to provide transportation each day to and from the designated HCS Summer Learning Academy site.
*
Yes
No
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