2020 CHCCS Middle School 101 Registration Form for Rising 6th Graders
Thank you for your interest in CHCCS Middle School 101 Program! This exciting summer program is designed to provide students with unique and engaging opportunities to become familiar with their middle school and to build the organizational, social, and personal skills needed for success at the middle school level.

Middle School 101 will be held during the week of August 3rd and will occur two times per day (AM/PM Session) where students will be assigned on of the sessions in order to serve as many students as possible. Please be sure to complete and return the form NO LATER THAN June 5, 2020 so that we can plan for you!
Middle School for the 2020-2021 School Year *
Student's First Name: *
Student's Last Name: *
Race
Gender
Student's PowerSchool Number/Lunch Number: *
Parent/Guardian’s Name(s): *
Parent's phone number: (Home) (Work) (Cell) - Please provide all three: *
Parent's email address: *
Parent's home address: *
Cont from previous - City and Zip Code *
Current Elementary *
Special Health Conditions (allergies, seizures, etc.)
Emergency Contact Person (if parent/guardian can’t be reached) *
Parent/Guardian(s) Authroization by providing your First Name, Middle Initial and Last Name: *
Submit
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