2026-2027 Churchill Elementary HSA Membership
We are excited for another WILD year at Churchill! We hope that you join us in the fun! Annual membership is $10 per family.
Part 1 - Parent Information
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Email Address
*
example@example.com
Additional Parent/Guardian Name
First Name
Last Name
Additional Parent/Guardian Email
example@example.com
Are you a Churchill Staff Member?
*
Yes
No
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Part 2 - Student Information
Note: If you are a Churchill staff member without children at this school, type and select "N/A" for Student 1.
Student #1 Name
*
First Name
Last Name
Student #1 Grade
*
K
1
2
3
4
5
N/A
For the upcoming school year.
Student #1 Teacher
*
Type Unknown and HSA will update after the start of the new year!
Student #1 T-shirt Size
*
Youth XS
Youth S
Youth M
Youth L
Youth XL
Adult XS
Adult S
Adult M
N/A
Student #2 Name
First Name
Last Name
Student #2 Grade
Kindergarten
1st
2nd
3rd
4th
5th
For the upcoming school year.
Student #2 Teacher
Type Unknown and HSA will update after the start of the new year!
Student #2 T-shirt Size
Youth XS
Youth S
Youth M
Youth L
Youth XL
Adult XS
Adult S
Adult M
Student #3 Name
First Name
Last Name
Student #3 Grade
Kindergarten
1st
2nd
3rd
4th
5th
For the upcoming school year.
Student #3 Teacher
Type Unknown and HSA will update after the start of the new year!
Student #3 T-shirt Size
Youth XS
Youth S
Youth M
Youth L
Youth XL
Adult XS
Adult S
Adult M
Student #4 Name
First Name
Last Name
Student #4 Grade
Kindergarten
1st
2nd
3rd
4th
5th
For the upcoming school year.
Student #4 Teacher
Type Unknown and HSA will update after the start of the new year!
Student #4 T-shirt Size
Youth XS
Youth S
Youth M
Youth L
Youth XL
Adult XS
Adult S
Adult M
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Part 3 - Family Contact Information (Optional)
The following parent/student contact information will be included in the 2026-2027 Churchill Elementary Directory. If you do not want specific information included, please leave question or form blank.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
-
Area Code
Phone Number
Alternative Phone Number
-
Area Code
Phone Number
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Part 3 - Membership Enrollment
Complete the payment information below to enroll in the 2026-2027 Churchill Home & School Association. Thank you for joining!
Annual Family Membership to Churchill HSA:
*
Family Membership Fee is $10.00 per year.
Additional Donation:
If you'd like to include an additional contribution with your Membership Purchase, enter the amount here.
Total:
Total:
*
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( X )
USD
Enter Total Amount: $10.00 Membership Fee + any Additional Donations
Credit Card
Submit
Should be Empty: