In-School Program Form
Site ID
Site Owner
Contact Information
First Name
Last Name
Email Address
What grade are you in?
Please select...
6
7
8
9
10
11
12
Date of Birth
(MM/DD/YYYY Format
)
Sex
Please select...
Male
Female
Prefer not to answer
Cell Phone Number
School ID
What school do you go to?
Do you want to receive texts from H2O?
Would you like to opt-in to receiving text messages from H2O? You can expect to receive 2-4 messages per month about fun events or calendar reminders. Standard messaging and data rates will apply. You can opt-out any time.
Guardian Information
Guardian First Name
Guardian
Last Name
Guardian
Cell Phone
Relationship
Please select...
Mom
Dad
Step-Mom
Step-Dad
Guardian
Foster Parent
School Record ID