All fields marked with * are required fields RM_StatsChoose Your School * Blacklick Valley School District Cambria Heights High School Conemaugh Valley School District Portage Area School District Rockwood School District Glendale School District Northern Cambria Middle School Somerset Area Junior Senior High School River Valley School District Please fill out the form below to register for Pledge Together. A parent/guardian signature is required, so make sure a parent/guardian is available to sign the form.First Name *Last Name *GradeSelect an option6th7th8th9th10th11th12thT-Shirt SizeSelect an optionSmallMediumLargeXL2XL3XL Your School Email *Username *Password *Password must be at least 7 characters long.Enter password again *Password must be at least 7 characters long.Be sure to save your password. You will need to contact your advisor in order to reset it. When you join Pledge Together, you agree not to vape, or use tobacco, alcohol, or other illegal drugsStudent Signature *Student SignatureStudent Certification * I pledge not to vape, or use tobacco, alcohol, or other illegal drugs. A parent/guardian signature is required to enroll in the program. Please have your parent/guardian sign the form below.Parent/Guardian First Name *Parent/Guardian Last Name *Parent/Guardian Signature *Parent/guardian signatureParent/Guardian Certification * I certify than I am the legal parent/guardian of the registering student and that they have my permission to participate in the Pledge Together program. Parent/Guardian Email * Subscribe (parent email) to keep up with news on Pledge Together and how Remembering Adam is making an impact Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
