1. 1 Registration Form
  2. 2 Review
  3. 3 Payment Details
  4. 4 Receipt

= Required

Super Summer 2020

Monday, July 6 to Friday, July 10, 2020

Houghton Academy
9790 Thayer St
Houghton, NY 14744

Student Information



Red School:Students completing 7th grade in Spring 2020.
Blue School: Students completing 8th grade in Spring 2020
Orange School: Students completing 9th grade in Spring 2020.
Yellow School: Students completing 10th grade in Spring 2020
Green School: Students completing 11th grade in Spring 2020
Silver School: 2020 High School Graduates
Room mates must be in the same school!

Parent Information

IMPORTANT:: Communication regarding Super Summer will be done primarily by email. Please make sure to enter a valid email address that will be checked by the student's parent or guardian.

Father's Information

Mother's Information

Emergency Information

MEDICAL INSURANCE (Please send in a photocopy of your insurance card along with your other registration information)


SECONDARY EMERGENCY CONTACT
In the case of an emergency, Super Summer will contact the parent or legal guardian immediately. If we are unable to reach you, please list a secondary contact person whom we can call. This person must be someone not living in the same household.

MEDICAL INFORMATION

Please check each condition that applies, whether they have had them previously or presently. If you check any box, you MUST give more detail in the text box below.