Clone of Summer School 2026 Registration

2026 Summer Program Registration Form

May 26th- June 18th
Student Name

First NameMiddle NameLast Name
What grade is your child in?
Student Birth Date

MonthDayYear
Student's Primary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please list food allergies or other medical related concerns:
Ex: Peanut Allergy
Is your child a currently enrolled at AZ Aspire Academy?
Family Information
Parent/Guardian 1

First NameLast Name
Is Parent/Guardian 1 authorized to pickup student?
Parent E-mail
example@example.com
Phone Number

Area CodePhone Number
Parent/Guardian 2

First NameLast Name
Is Parent/Guardian 1 authorized to pickup student?
Parent 2 E-mail
example@example.com
Phone Number

Area CodePhone Number
Emergency Contact 1

First NameLast Name
Is Emergency Contact 1 authorized to pickup student?
Relationship
Phone Number

Area CodePhone Number
Emergency Contact 2

First NameLast Name
Is Emergency Contact 2 authorized to pickup student?
Relationship
Phone Number

Area CodePhone Number
Program Details
What Funding Source(s) are you utilizing for the Summer School Program?

Other
By signing below, you agree to register your child in the 2026 Summer Program at AZ Aspire Academy. This program is tuition based with a total cost of $3,250.
Additional Comments
Should be Empty:

2026 Summer Program Registration Form