2017 Summer Bridge Program Registration
Welcome to the Phantom Family! Summer Bridge is the transition program for ALL incoming 9th grade students. It will be held Monday, August 14th - Thursday, August 17th, from 8:30am - 12:30pm. Please complete this form to register your child for the program. Please email Ms. Elazier at gelazierharris@hampton.k12.va.us with questions. Thank you!
Student First Name
Your answer
Student Last Name
Your answer
Student Date of Birth
Your answer
Student Sex
Required
Student Address
Please include City if not Hampton
Your answer
Student Home Telephone
Your answer
Student Shirt Size (Adult Sizes)
Required
Parent/Guardian First & Last Name
Your answer
Parent/Guardian Cell
Your answer
Parent/Guardian Email
Required to receive bus route information; if none, then state "None" in the response.
Your answer
Will you be attending the Parent Session on Monday, 8/14?
This optional session is an informal introduction to the administrative staff.
Required
Will your child need bus transportation?
Transportation cannot be provided for out of zone students.
Required
Will your child require special accommodations?
For families planning to utilize IEP & 504 accommodations in the fall.
Required
What math class will your child be taking in the 9th grade?
Emergency Contact First & Last Name AND Relationship to Student
Your answer
Emergency Contact Phone Number
Your answer
I understand that Summer Bridge activities may be photographed and used on HCS media sites. By checking below I authorize the use of my child's picture for HCS publishing purposes.
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