Co-Curricular Activity Sign-Up
Register for school co-curricular activities. Please complete all required information to secure your spot.
Full Name
*
First Name
Last Name
Date of Birth
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Grade
*
Please Select
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Select Activity
*
Please Select
Drama Club
Robotics Team
Art Society
Music Band
Debate Team
Sports Club
Other
Preferred Meeting Days
*
Monday
Tuesday
Wednesday
Thursday
Friday
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email
*
example@example.com
Emergency Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Does the participant have any allergies or medical conditions?
*
No
Yes (please specify below)
If yes, please specify allergies or medical conditions
Special Needs or Accommodations Required
Submit Registration
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