High School Initiative: Summer Registration
Girl's Name *
Birthdate
MM
/
DD
/
YYYY
Address (including City, State, Zip Code)
Grade as of August 12th, 2019 *
School *
T-Shirt Size (Adult) *
Does your child receive lunch assistance? *
Who does this child live with?
Clear selection
Number living in household? *
Household Income Per Year
Clear selection
Primary Language Spoken at Home *
Race *
Required
Military Family *
Primary Guardian Name
Primary Guardian Role *
Required
Primary Guardian Email Address *
Primary Guardian Phone Number *
Emergency Contact Info (Name, Phone, Relationship)
Food/General Allergies *
Parental Consent:
My girl will be attending the following weeks: *
Required
Girl's Name *
Birthdate
MM
/
DD
/
YYYY
Address (including City, State, Zip Code)
Grade as of August 12th, 2019 *
School *
T-Shirt Size (Adult) *
Does your child receive lunch assistance? *
Who does this child live with?
Clear selection
Number living in household? *
Household Income Per Year
Clear selection
Primary Language Spoken at Home *
Race *
Required
Military Family *
Primary Guardian Name
Primary Guardian Role *
Required
Primary Guardian Email Address *
Primary Guardian Phone Number *
Emergency Contact Info (Name, Phone, Relationship)
Food/General Allergies *
Parental Consent:
My girl will be attending the following weeks: *
Required
Girl's Name *
Birthdate
MM
/
DD
/
YYYY
Address (including City, State, Zip Code)
Grade as of August 12th, 2019 *
School *
T-Shirt Size (Adult) *
Does your child receive lunch assistance? *
Who does this child live with?
Clear selection
Number living in household? *
Household Income Per Year
Clear selection
Primary Language Spoken at Home *
Race *
Required
Military Family *
Primary Guardian Name
Primary Guardian Role *
Required
Primary Guardian Email Address *
Primary Guardian Phone Number *
Emergency Contact Info (Name, Phone, Relationship)
Food/General Allergies *
Parental Consent:
My girl will be attending the following weeks: *
Required
Girl's Name *
Birthdate
MM
/
DD
/
YYYY
Address (including City, State, Zip Code)
Grade as of August 12th, 2019 *
School *
T-Shirt Size (Adult) *
Does your child receive lunch assistance? *
Who does this child live with?
Clear selection
Number living in household? *
Household Income Per Year
Clear selection
Primary Language Spoken at Home *
Race *
Required
Military Family *
Primary Guardian Name
Primary Guardian Role *
Required
Primary Guardian Email Address *
Primary Guardian Phone Number *
Emergency Contact Info (Name, Phone, Relationship)
Food/General Allergies *
Parental Consent:
My girl will be attending the following weeks: *
Required
Girl's Name *
Birthdate
MM
/
DD
/
YYYY
Address (including City, State, Zip Code)
Grade as of August 12th, 2019 *
School *
T-Shirt Size (Adult) *
Does your child receive lunch assistance? *
Who does this child live with?
Clear selection
Number living in household? *
Household Income Per Year
Clear selection
Primary Language Spoken at Home *
Race *
Required
Military Family *
Primary Guardian Name
Primary Guardian Role *
Required
Primary Guardian Email Address *
Primary Guardian Phone Number *
Emergency Contact Info (Name, Phone, Relationship)
Food/General Allergies *
Parental Consent:
My girl will be attending the following weeks: *
Required
Girl's Name *
Birthdate
MM
/
DD
/
YYYY
Address (including City, State, Zip Code)
Grade as of August 12th, 2019 *
School *
T-Shirt Size (Adult) *
Does your child receive lunch assistance? *
Who does this child live with?
Clear selection
Number living in household? *
Household Income Per Year
Clear selection
Primary Language Spoken at Home *
Race *
Required
Military Family *
Primary Guardian Name
Primary Guardian Role *
Required
Primary Guardian Email Address *
Primary Guardian Phone Number *
Emergency Contact Info (Name, Phone, Relationship)
Food/General Allergies *
Parental Consent: