2021 Frazier Summer Learning Program K-8 Registration
Please fill out the online registration form below to register for the Frazier Summer Learning Program. If more than one student will be attending please make sure to fill out a separate form for each student.

Students must attend all day 9:00AM to 2:00PM (current grades K-8). Lunch will be provided. Program cost is free.

Space is limited and is available on a first come first serve basis. You will receive an email confirmation within 3 days upon receiving your online registration to confirm your spot is held. Registrants will receive official confirmation of enrollment once all forms are received.

• Dates: June 21 - July 16, 2021, (4-week program, 3 days a week: Tuesday, Wednesday, and Thursday)
• Time: 9am-2pm
• Location: Frazier Elementary
• Face-to-face instruction with certified teachers in ELA and Math
• 1/2 day ELA and ½ day Math
• Integrated STEM activities daily
• Pre and Post assessments in ELA and Math
• Transportation will be provided by the district for Frazier students only.
• Technology will be provided by the district for Frazier students only.

Photo Release Form and Release from Reliability Form can be found at https://sites.google.com/iu1.org/innovationanddesign/student-programs
Contact Information
Parent/Guardian(s) Name *
Primary Phone Number *
Please list the number in which you can best be reached in case of an emergency.
Alternate Phone Number *
Please list a second number, that we can use to reach you in case you cannot be reached at the primary phone number. If the number is for another family member, please indicate their name along with the number.
Email *
Street Address *
City *
State *
Zip Code *
Student Information
Student's First Name *
Student's Last Name *
Gender *
School Child Attends *
Grade *
Photo Release
Please complete the information below as well as returning the signed IU1 Photo Release Form.
Your child's picture may be taken for the local newspaper or for special program presentations. Kindly give us permission or decline permission to include your child in pictures by indicating your response below. *
Please make sure to sign and return the formal Photo Release Form found at http://www.iu1.org/services/innovation-and-design.
Required
Medical Form Release
Emergency and Medical release information for Summer Learning Program. Please complete all information below in order to successfully register for the Summer Learning Program. Please mark all fields that DO NOT apply with N/A.
Parent/Guardian Name
Please indicate if the information is different from the above contact information.
Allergies *
Medications *
Medical Conditions *
Dietary Restrictions *
Emergency Contact *
In case of an emergency, please contact (other than parent).
Physician/Physician Phone Number *
In case of an emergency, please contact (other than parent).
Handicap Accessibility *
Required
Handicap Accessibility *
If "Yes" was selected above, please explain requirements below.
Summer Learning Program Policy Information
BEHAVIOR POLICY - The Summer Learning Program reserves the right to remove disruptive students from the program. In this unlikely event, the parent(s) will be required to pick up their student immediately.

TECHNOLOGY POLICY - Personal electronic devices (iPods, iPads, Kindles, Nintendo, etc.) are not permitted during the Summer Learning Program, unless otherwise noted by the instructor. Cell phones are the ONLY exception however they must remain stored in the student's backpack, etc. only to be used in a case of emergency. If a student is using technology inappropriately the item will be kept aside by an instructor for the remainder of the day. Multiple infractions will result in the student being dismissed from the Summer Learning Program.
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