2022 9th Grade Counts Summer Academy             David Douglas High School                       Registration Form
Please complete registration for your student. Note, there is a $10 fee (can be paid later). Students on the waitlist may be added if space permits. THIS FORM MUST BE COMPLETED BY A PARENT OR GUARDIAN.
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Email *
Student First Name *
Student Last Name *
Student ID # *
Student Gender *
Student Unisex T-Shirt Size *
Parent/Guardian First and Last Name *
Street Address *
City, State, Zip code *
Parent Phone Number *
Parent Email *
Middle School Attending *
Home Language Spoken *
8th Grade Math Class *
8th Grade English Class (regular, advanced, other) *
Please list and describe and health issues or medications that your child has that we should be aware of  (Type None if there are none): *
Any allergies we should be aware of? *
Name of emergency contact *
Emergency Contact phone number: *
Emergency Contact Relationship to student *
By typing my digital signature on this form, I indicate the I have read, understand, and agree to abide by the Ninth Grade Counts Summer Academy Policies. A letter that confirms acceptance into the Ninth Grade County Summer Academy will be mailed to the address given above.                                                                                    Please type Parent/Guardians first and last name: *
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