Elevate Bridgeport

Senior Sendoff

Monday, June 15th, 2026

2:30 pm to 5:30 pm

Student's First Name

Student's Last Name

Student's Phone Number

Student's Email

Parent/Guardian full name

Parent/Guardian Phone Number

Emergency Contact Full Name

Emergency Contact Phone Number

What school do you attend?

I give permission for my child to go with Elevate Bridgeport Staff to the Elevate Office for the Senior Sendoff.

I hereby grant Elevate Bridgeport permission to use my likeness in a photograph, video, or other digital media in any and all it's publications and social media.