Summer Spark Registration

Part 1: Student Information/Informacion del Estudiantie:

Namerequired

First Name/Nombre

Middle (optional)

Last Name/Apellido

Summer Spark Session Enrollmentrequired

Junior Jaguars Basketball - June 12-16 ($10.00)

Junior Jaguars Soccer- June 19-23 ($10.00)

Junior Jaguars Volleyball- June 26-30 ($10.00)

SJA Theater & Dance Camp Session 1 - June 12-16 ($10.00)

SJA Theater & Dance Camp Session 2 - June 19-23 ($10.00)

SJA Theater & Dance Camp Session 3 - June 26-30 ($10.00)

Please note: Students can register for as many sessions as they would like. Students that enroll in concurrent sessions, ex: Junior Jaguars Basketball & SJA Theater & Dance Camp that run on the same day will also be served a complimentary lunch.

T-Shirt Sizerequired

Home Address/Domiciliorequired

City/Ciudadrequired

State/Estadorequired

Zip Code/Código Postalrequired

Phone Number/Número de teléfonorequired

Email/Coreo Electronicorequired

Date of Birth/Fecha de Nacimientorequired

Must contain a date in M/D/YYYY format

Current School Attending/Escuela Actualrequired

Grade Level/Gradorequired

Preferred language(s) spoken at home/Idioma de preferenciarequired

How did you hear about SJA?/Como escuchaste sobre SJA?required

Part 2: PARENT/GUARDIAN Information/Información de Padre Guardián:

Namerequired

First Name/Nombre

Last Name/Apellido

Relationship to Student/Relación al Estudiante: required

Address/Domiciliorequired

City/Ciudadrequired

State/Estadorequired

Zip Code/Código Postalrequired

Email Address/Coreo Electronico required

Home Phone/Número de Casarequired

Cell Phone/Cellularrequired

Name of Employer/Empleadorequired

Work Phone/Numero del Trabajorequired

I am the primary parent/guardian in the household where the student lives. Soy el padre/tutor en el hogar donde vive el estudiante.required

Yes/Si

No

Parent/Guardian 2

Name

First Name/Nombre

Last Name/Apellido

Relationship to Student/Relación al Estudiante:

Address/Domicilio

City/Ciudad

State/Estado

Zip Code/Código Postal

Email Address/Coreo Electronico

Home Phone/Número de Casa

Cell Phone/Cellular

Name of Employer/Empleado

Work Phone/Numero del Trabajo

Part 3: Health Questionaire

Do you have any allergies that require medication/intervention?required

Yes

No

Please explain the allergy and if any medication or intervention is needed due to exposure.

Do you have any existing medical conditions that require medicine to be dispensed while at SJA?required

Yes

No

Please explain the allergy and if any medication or intervention is needed due to exposure.

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Payment Information