2017 Summer Academy Registration Form
Please fill out a new form for each child you are enrolling in a Summer Academy class. If you have more than one child you can click on the "submit another response" button at the end and enroll another child.

Payment and registration will need to be submitted by May 2, 2017. You can send your payment in with your child. Please put on the envelope that it is for Summer Academy / ATTN: Barb Knauff. If you would like to mail your payment, please mail it to Barb Knauff, Hermitage School District, 411 N. Hermitage Road, Hermitage, PA 16148.

If after reviewing the course information you find that the course is not listed below, please contact Barb Knauff as this means the class is full and we can put your child's name on a standby list for any cancellations.

Please note the new format of the registration form requires you to check "YES" for any courses you wish to enroll your student. All other fields are automatically populated as a "NO" response.

Please call 724-981-8750 ext. 6010 with any questions you may have.

You can view the course information by clicking on this link: https://goo.gl/u78MrT

Email address *
Parent/Guardian First Name *
Your answer
Parent/Guardian Last Name *
Your answer
Street Address *
Your answer
Home Phone Number *
Your answer
Cell Phone Number *
Your answer
Name of an Emergency Contact Person *
Your answer
Phone Number of Emergency Contact Person *
Your answer
Student First Name *
Your answer
Student Last Name *
Your answer
Student will be Entering this Grade for 17-18 *
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