West County Middle School 2020 Summer School Enrollment Form
** If Social Distancing Restrictions are Lifted **
Dates: June 16 - July 10 - 8:00 a.m. - 3:00 p.m.
You must complete a registration form for EACH student enrolling.
Student First Name *
Student Last Name *
Grade going into: *
Address *
City *
Zip Code *
Parent/Guardian Name *
Parent/Guardian Home Telephone Number *
Parent/Guardian Work Telephone Number
Name of Emergency Contact #1
Emergency Contact #1 Telephone Number
Name of Emergency Contact #2
Emergency Contact #2 Telephone Number
Check pickup at school or the bus drop off location your child will ride to: *
Required
Submit
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