Student Information

First Name*

Last Name*

Date of Birth*

Current Grade Level*

Student ID*

Parent/Guardian Information

First Name*

Last Name*

Relationship*

Email*

Phone Number*

Extracurricular Activity Choices

Please select the extracurricular activities you would like to register for:

Community Service

Volunteer ClubEnvironmental ClubPeer TutoringOther(Please specify)

Other Interests

Coding/ProgrammingCreative WritingForeign Language ClubOther(Please specify)

Health and Safety Information

Does your child have any allergies or medical conditions that the activity coordinators should be aware of?*

YesNo

If yes, please specify

Does your child require any special accommodations or support during these activities?*

YesNo

If yes, please specify

Terms and Conditions *

Eligibility: Participants must meet the eligibility criteria set by the institution or program. This may include age, grade level, or other requirements specific to the activity.

Attendance: Regular attendance and participation in scheduled activities is expected. Failure to meet attendance requirements may result in dismissal from the activity.

I have read and understood all the instructions/terms and conditions.

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WordPress Extracurricular Activities Registration Form

Student Information

Parent/Guardian Information

Extracurricular Activity Choices

Health and Safety Information