Summer School Enrollment Kindergarten-5th

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Please complete this form to enroll your student in our exciting summer school program!

We will be together from May 31st to June 27th from 7:50 to 2:30. Doors open at 7:20 for breakfast at the elementary and breakfast and lunch will be provided free of charge to our students. We look forward to seeing your child soon!

Email *

Which school will your child attend NEXT YEAR? *

Early Childhood Center (Kindergarten - 1st Grade)

Elementary (2nd - 5th)

Student Full Name *

Date of Birth *

YYYY

Ethnicity *

Non-Hispanic

Hispanic

Race (Check all that apply) *

Caucasian

African American

Native American/Eskimo

Pacific Islander

Required

Gender *

Male

Female

Parent/Guardian Name *

Physical Address *

Please provide mailing address if different than physical address.

Phone Number *

Email Address *

Emergency Contact Name *

Emergency Contact Phone Number *

Current School District Attending *

The grade your student will be in NEXT YEAR: *

Kindergarten

First

Second

Third

Fourth

Fifth

Does your student have any food allergies? Please list any or respond N/A if not applicable. *

After school my student will: *

Attend Tiger Academy: This will require enrollment in the summer Tiger Academy Program to attend. Enrollment does not guarantee placement as we are working from a waiting list at this time.

Be picked up

Ride the Bus

If riding the bus, will your student need transportation every day?

Yes

Clear selection

If no is selected, please indicate which days your student will be riding the bus.

If your student is riding the bus in the AFTERNOON, please use the chart to indicate the bus your child will be riding. Times are listed for your convenience.

Bus 1

Bus 2

Bus 3

Bus 4

Bus 5

Bus 6

Bus 7

Bus 8

Clear selection

Please provide the physical address for afternoon student dropoff.

To grant permission for your child to attend summer school field trips, please sign below (digital type). All field trips will be held within the school day, and teachers will send all information home prior to the trip. *

The school will occasionally take pictures, video, interview, and/or record school events to be used in our school newsletter, website, social media, newspaper articles, print or digital news media, and yearbook. That information may contain the following but will not be inclusive of: Name, Photograph, Awards, and Participation in Activities. By signing below, I (parent/guardian) give my permission for the Hollister R-V School District to release information as needed. *

Please sign below (digital type) to complete the enrollment process. *

Submit

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