Shake Off Competition Registration
The Shake Off is a competition that places an emphasis on teaching students manners, discipline, respect, and professional conduct. The goal is to prepare our students so that they are able to present themselves exceptionally well for opportunities today as well as those that will come in the future.
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Parent/Guardian Email Address *
Student Date of Birth *
MM
/
DD
/
YYYY
Chaperone Name *
Chaperone email *
Chaperone Relationship to student *
Student Grade *
Student Email Address
School Name *
Dietary Restrictions *
Emergency Contact Name and Phone Number *
*
Captionless Image
I hereby hold harmless and release Churchland High School from all liability, petitions, and causes of action which I, my heirs, representative, executors, administrators, or any other persons may make while acting on my behalf or on behalf of my estate. *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Portsmouth Public Schools. Report Abuse
Google Forms