Young Hearts for Life Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

To be completed by parent/guardian of all students who would like to participate. THERE ARE TWO SECTIONS TO COMPLETE. You must complete both for your child to be registered.

Read here for parent/guardian welcome letter: https://drive.google.com/file/d/1OoFtRF6d7frwmVGwyXHRC3Q97DCrdXmK/view?usp=sharing

This is our 2nd time having YH4L in our school. The first time was very successful and led to some wonderful discussions/education, as well as valuable information for some of our students in relationship to their heart health.

Please enter e-mail address of parent/guardian below.

Email *

SECTION # 1: Parent/Guardian permission. https://screenings.yh4l.org/YH_enroll.aspx?echo=true You must visit this site and give permission. When asked for a STUDENT ID, please use the one that the district assigned- the same one used for your lunch login. *

I did this step and YH4L now has my child's consent form on file

Required

Clear form

Never submit passwords through Google Forms.

This form was created inside of Mahomet Seymour CUSD#3. Report Abuse

Forms