Summer Reading Program - Ladies Of Leadership

Summer Reading Program Application

Our program takes place Monday-Friday 8:00 am-4:00 pm. Before and after care will be available upon request for an additional fee.

To secure your spot, there is a $75.00 non-refundable registration fee. The cost is $150.00 per week (multi-child discounts available) with breakfast, lunch, and snack included. Onsite tutoring will also be available.

We can’t wait to get started! There will be power packed days full of fun, learning and outdoor activities!

Space is limited. Each participant must provide their own laptop or Chromebook.

Please Note* CDC GUIDELINES WILL BE IMPLEMENTED

Participant's First Name

Participant's Last Name

Date of Birth

Address

Ethnicity

City

State

Zip Code

School

Grade Completed as of June 2024

Please upload your child's MOST RECENT report card or progress report

Parent Name

Cell Phone Number

Emergency Contact Name & Phone Number #1

Emergency Contact Name & Phone Number #2

Parent/Child's School Login for Grades, i.e. Progress Book

Is your child a participant in the IEP or 504 Plan?

Yes No

Is your child on a Free or Reduced-Price Lunch Program?

Yes No

PICK UP: My child will be picked up from the program by:

Allergies (medications, foods, etc.)

Is your child currently on any medication that will need to be administered during the program, including inhalers?

Yes No

If yes, written permission from a parent or guardian will be necessary to accompany the medication and the medications must be self-administered.

Yes, I will provide written permission Not Available (Select this option if you selected no to the previous question)

Is there any additional information you would like us to know about your child to help us give them the best experience possible?

Emergency Release: I give permission, in the event of an emergency, for first aid to be administered to my child and emergency medical treatment including transportation by ambulance to the nearest hospital, should it be necessary. I understand that every effort will be made to contact me.

I accept the terms as stated above.

Summer Reading Program Application

Our program takes place Monday-Friday 8:00 am-4:00 pm. Before and after care will be available upon request for an additional fee.

To secure your spot, there is a $75.00 non-refundable registration fee. The cost is $150.00 per week (multi-child discounts available) with breakfast, lunch, and snack included. Onsite tutoring will also be available.

We can’t wait to get started! There will be power packed days full of fun, learning and outdoor activities!

Space is limited. Each participant must provide their own laptop or Chromebook.

To pay for your registration and subsequent payments, please click PAY NOW below.