Student Kick-off Registration Form

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We are looking forward to the upcoming Student Kickoff! It will be held at the Boutwell Auditorium on the following days:

May 13, 2019: Clay-Chalkville Middle, Hueytown Middle, Erwin Middle, Rudd Middle, Fultondale High, Tarrant High

May 14, 2019: Bessemer Middle, McAdory Middle, Rutledge Middle, Minor Middle, Irondale Middle, Fairfield High, Pleasant Grove High

Please take a moment to register for the event.

Name *

School *

Bessemer Middle

Clay-Chalkville Middle

Erwin Middle

Fairfield Prepartory High School

Fultondale High School

Hueytown Middle

Irondale Middle

McAdory Middle

Minor Middle

Pleasant Grove High School

Rudd Middle

Rutledge Middle

Tarrant High School

Other:

Position *

Student

Teacher

School Coordinator

Partner

District Administrator

Volunteer

UM Faculty/Staff

Other:

What grade are you in?

6th grade

7th grade

Not Applicable

Clear selection

Lunch preference *

Ham Sandwich

Turkey Sandwich

Veggie Wrap

Gluten Free (Turkey)

Not staying for lunch

IF YOU ARE A STUDENT, what is your T-shirt size? (Adult Sizes)

XXL

I am not a student

Clear selection

A free t-shirt will be provided for each GU-JC student. Additional t-shirts can be purchased for $5. If you are interested in purchasing a t-shirt, please indicate below. (All sizes are adult sizes)

XXL

I do not wish to purchase a t-shirt at this time

Clear selection

Submit

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