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Hopeworks Registration
When we meet:
Wednesdays (Middle School) Thursday (High School) 3:30-6:00pm for both days
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Email
*
Your email
Student Name
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Your answer
Student Date of Birth
*
MM
/
DD
/
YYYY
Student Grade
*
6
7
8
9
10
11
12
Other:
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School where student attends
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Your answer
Student Cell (if applicable)
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Your answer
Student Email
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Your answer
What do we need to know about your student in order for us to meet them where they are? (Special learning challenges, dietary restrictions, health issues, etc.)
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Your answer
Parent(s) Name(s)
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Your answer
Parents Cell
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Your answer
Parents Email Address
*
Your answer
Home Address
*
Your answer
Emergency Contact Information (Name/Number)
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Your answer
***In order to ensure the safety of all students attending Hopeworks, all students attending must not have a record of violence, sexual assault, or anything that puts others at risk***
By clicking 'I agree' below, you are agreeing to this statement. Students who have a record of violence or the like are not permitted to attend Hopeworks.
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