WRAP Virtual Fall Registration AYA

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Email *

Select WRAP / AYA site

Avalon

Birney

Bryant

Franklin

Gompers

Hamilton

Jefferson

Keller

Lindbergh

MacArthur

Marshall

Powell

Rogers

Signal Hill

Tincher

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Student Name: *

Student Date of Birth: *

YYYY

Student ID *

Student Grade in 2020-2021 *

Parent/Guardian Name: *

Parent Contact Number: *

Emergency Contact Name: *

Emergency Contact Number: *

Release for permission to participate in the evaluative survey. *

Yes, I agree to all my student to participate in any evaluative survey related to the WRAP program.

Release for permission to photo, video, and sound record. *

I hereby release, discharge, and agree to hold harmless the Long Beach Unified School District and those acting under its permission from any liability to the extent permitted by law, for the preparation, distribution, and use of photos, videos, and/or sound recordings.

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