Online Health Registration Form

SJCA Summer Health or Gym Registration Form

Summer 2026
Which class are you signing up for:
Student Full Name

First NameLast Name
Student Email
example@example.com
Student Grade in the 26-27 school year:
Student Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Phone

Area CodePhone Number
Parent/Guardian Name

First NameLast Name
Parent/Guardian Email
example@example.com
Parent Cell Phone

Area CodePhone Number
**For Summer Health Students** My student is requesting ONLINE SUMMER HEALTH. Check one box below for the course replacement that will fill the open spot in your student's Freshmen schedule.
I understand that in order to participate in the SJCA Summer Heath or Personal Fitness Class, my student must be registered for the 26-27 school year?
By signing this form, I understand that my child, listed above, is registering for the ONLINE Summer Health Course or the Summer Personal Fitness Course.

By signing this form I understand that this course is designed for independent learning.

By signing this form I understand that I will not receive a refund for this course for any reason. However, my child may drop this course by Thursday, June 25th, and will be enrolled in the Fall 2026 or Spring 2027 semester with no credit for work already completed.
Parent Printed Name
Signature
The cost of each class is $250. Please submit checks made out to SJCA to the main office. Payment must be recieved before a student will be enrolled in this course.
Should be Empty:

SJCA Summer Health or Gym Registration Form