Bolt Blast Registration 2020
BOLT BLAST IS SUBJECT TO CHANGE DUE TO COVID-19 AND THE GOVERNOR'S ORDERS FOR OUR STATE. AS WE GET INFORMATION, WE WILL LET YOU KNOW IF AND WHEN BOLT BLAST WILL OCCUR.

Bolt Blast will run daily from July 27, 2020 to July 31,2020 from 8:30-11:30am.  

Please complete the information below. Registration will be accepted to the program on a first come, first serve basis with a maximum of 240 students. Registration is NOT complete until payment of $100 is received by Seneca Ridge Middle School.

** Payments may be made via the LCPS Online Payment System. After submitting the application, please click on the link on the confirmation page to go to the LCPS Online Payment System. Payment can also be submitted via cash/check in the main office at Seneca Ridge.  Scholarships are available. **

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電子郵件 *
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Student Last Name *
Student First Name *
Current Elementary School *
必填
If other, please write name of Elementary school here:
Parent Name *
Home Address *
Phone number *
Child's shirt size *
Adults picking up your child *
My child has permission to walk home from Bolt Blast *
Does your child have allergies? *
If so, please list allergy here:
If you may need financial assistance please check here
Is there anything else we should know about your child to make Bolt Blast a successful experience for them?
*By entering your full name below, you are effectively providing your signature, indicating that all the information on this form is true and accurate, to the best of your knowledge and are agreeing to the above and below conditions.* Parent will provide on-time TRANSPORTATION to/from the Bolt Blast program; and provide any relevant and necessary medical information to the Bolt Blast program prior to its start. Failure to do so can result in your child being withdrawn from the program. Finally, parent will submit the $100 payment to Seneca Ridge Middle School via the electronic payment system (link below), in person, or by mail. Until payment is received,  child is not enrolled.  Click below for online payment portal: https://osp.osmsinc.com/LoudounVA/BVModules/CategoryTemplates/Detailed%20List%20with%20Properties/Category.aspx?categoryid=DB003  *
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