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Youth Academy Sign Up Form


  1. 1. Basic Information
  2. 2. Emergency Contact Information
  • Basic Information

    1. *Program will run from 8:00AM to 3:00PM and will be located at the Chicopee Comprehensive High School. *Parents are reminded this is a 1-week commitment & attendance is mandatory due to the number of applicants wanting to attend. *Space is limited. *Lunch & Water will be provided by the Chicopee Police Dept.
    2. Medical Concerns/Issues?*
    3. Are you currently taking any medication(s)? (Check one) *
    4. Food, environmental, pharmaceutical or other allergies? (Check one)*