Register Withdraw Student – Summerhill School Web Forms

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Academic Year*

I would like to*

Re-register my child at Summerhill

Submit withdrawal notice

Parent / Guardian Name*

Cellphone Number*

Email Address*

Optional — complete these fields if you would like us to record a second parent or guardian.

Second Parent / Guardian Name

Second Parent Cellphone Number

Second Parent Email Address

Child's First Name*

Child's Surname*

Current Grade & Class*

Please complete the following information for the student’s withdrawal.

Date Student Will Finish at Summerhill*

Name of New School

Optional if the student’s next school has not yet been confirmed.

Reason for Leaving Summerhill School*

Re-Registration & Withdrawal