Summer Learning Exploration 2019 Registration Form
FORM MUST BE FILLED OUT BY MAY 31, 2019.
Site: Emmons Elementary School - 1306 South Main Street, Mishawaka, Indiana 46544
Transportation: Provided to and from your child's home school (refer to the bus schedule)
Dates: June 24 - July 24 (M-F) NOTE: No camp on July 4 and 5
Time: 8:30 AM - 3:00 PM
Meals: Breakfast and lunch will be provided
Fee: $20 Materials Fee
STUDENT AND PARENT/GUARDIAN INFORMATION
School Currently Attending
Current Grade (for 2018-19 school year)
City and Zip Code
Does Student have an IEP?
My Child Will Be Attending:
Morning Reading/Language Arts ONLY
Afternoon Math ONLY
$20 Materials Fee:
I will send payment to my child's school (make checks payable to School City of Mishawaka)
My child was approved for free/reduced lunches/textbooks for 2018-19 school year
My child will be riding the bus to and from their home school
Your child's school often has opportunities for positive media coverage. Staff of School City of Mishawaka and United Way may want to review, photograph, or videotape your child and/or their work for publications, television reports, public presentations, websites, and social media. Student work and information includes but is not limited to: child's photo; name; grade; age; drawings; materials; writings and/or quotations; photographs; and images.
Media Release Consent
Yes, I give my consent.
No, I do not give my consent.
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