JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
BIS Summer School Enrollment 2025
Please complete the enrollment process only
ONE
time, per child enrolled.
IF
you need to make changes later, please call the BIS office.
Summer School Dates: May 28-June 24. Summer School Time: 8:00am-2:30pm.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Student Name
*
Your answer
Student Date of Birth
*
MM
/
DD
/
YYYY
Is your child currently enrolled in the Bolivar School District?
*
Yes
No
Parent/Guardian Name(s)
*
Your answer
Parent/Guardian Phone Number
*
Your answer
Parent/Guardian Email Address
*
Your answer
Emergency Contact and Phone Number
*
Your answer
Student Grade Level Fall 2025
*
3rd Grade
4th Grade
5th Grade
Student's Current (2024-2025) Teacher
*
Your answer
Allergies? Please list them here or "none"
*
Your answer
If your child has siblings attending BPS or BIS for summer school, please list names and buildings here.
Your answer
Will your child need BUS transportation for summer school?
*Reminder* If you select that you need bus transportation, you must visit the district website to sign up for bus transportation.
*
Mornings only
Afternoon only
BOTH
NO
Will your child be car pick up?
*
Mornings only
Afternoons only
BOTH
NO
If your child will be car pick up, please provide the name(s) of individuals allowed to pick up during summer school.
*
Your answer
Afternoon class options: Rank your top 4. There is no guarantee that a student will get one of their top choices.
Select your top 4
Travel to Space
Stop Motion Studio
Gaming, Gaming, Gaming
Wanna Have Fun
The Game Wizard
Sports Academy
PE/Card Games
Spirit Squad Cheer
What In The World
Select your top 4
Travel to Space
Stop Motion Studio
Gaming, Gaming, Gaming
Wanna Have Fun
The Game Wizard
Sports Academy
PE/Card Games
Spirit Squad Cheer
What In The World
Clear selection
I understand summer school operates on a “3 strikes” discipline policy and that after 3 disciplinary infractions, my student will not be allowed to finish summer school. Also, students will go on various field trips throughout the session. **Please type your name HERE to accept the discipline policy
and
grant permission for field trips. This will complete your summer school registration! Thank you!!
*
Your answer
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Bolivar R-1 Schools.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report