High School Student Registration (2018-19)

High School Student Registration 2022-23
Student's Name *

First Name Last Name
Gender *

M F
Grade 2022-23 *
Birth Date *

Month Day Year
Student's Cell # *
Student's E-mail
Student Email Only; Not Parent Email; example@example.com
Home Street Address *
Home City *
Home Zip Code *
Parent/Guardian Information
Dad or Guardian's Name

First Name Last Name
Dad or Guardian's Cell #
Dad or Guardian's E-mail
Mom or Guardian's Name

First Name Last Name
Mom or Guardian's Cell #
Mom or Guardian's E-mail
example@example.com
Emergency Information
Emergency Parent/Guardian Contact Name *

First Name Last Name
Relationship *
Emergency Parent/Guardian Contact Cell # *
Email Address of Parent/Guardian for Communication *
Parent/Guardian Email Only; example@example.com
School Name *
Does the student have any allergies, chronic illness, or medical conditions? If yes, please describe or state None! *
PLEASE NOTE:

You are providing a mobile # & email address for the student & parent for emergencies & agreeing to receive text messages from txt 180 & emails from Mailchimp. We will also need a Parent Consent Form for each event your student attends; possibly non-refundable deposits & a copy of their health insurance card front & back. Please visit www.sharonstudents.com for more information.
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High School Student Registration 2022-23