Extra Curricular Programs Registration

Student Name: (Legal first, middle, last)

Date of Birth: (MM/DD/YYYY)

Is your child currently enrolled in Nova Bridge School?

Current Grade Level: (If not currently enrolled in your school, leave blank)

Home Address

City

Province

Postal Code

Parent/Guardian 1

Parent/Guardian 1 Complete Name (First, Last Name)

Relationship to Student(s)

Phone Number:

Parent/Guardian 2 (If applicable)

Parent/Guardian 2 Complete Name (First, Last Name)

Relationship to Student(s)

Phone Number:

Please select the extracurricular program(s) you wish to enroll your child in:

Is there any additional information you would like to share that may be relevant to your child's participation?

Date: November 24, 2024

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