Summer Program Registration

Enroll Now For Our Summer Academic Program!

The 2021 Summer Academic Program will run from June 7th through July 30th.

Here is a full list of all the sites available in our Summer Academic Program by location and grade. Students may only enroll in ONE site. Spots at each site are limited to first come first serve. We will be updating this list as sites fill up:

Brush Creek Community Center: Grades K-5 — 3801 Emanuel Cleaver II Blvd
Calvary Temple Baptist Church: Grades 6-8 — 2940 Holmes Road
Covenant Presbyterian: Grades 1-3 — 5931 Swope Parkway
Friendship Baptist Church: Grades K-5 — 3530 Chelsea
Garrison Community Center: Grades K-8 — 1124 E. 5th Street
Gregg Klice Community Center: Grades K-5 — 1600 John Buck O’Neil Way
Holy Cross: Grades K-8 from June 7th to July 23rd — 121 N. Quincy
Macedonia Baptist Church: Grades K-5 — 1700 E. Linwood Blvd
Metropolitan Missionary Baptist: Grades K-6 — 2310 E. Linwood
Palestine Missionary Baptist: Grades 1-5 — 3619 E. 35th Street
St. James United Methodist: Grades K-4 — 5540 Wayne
Upper Room Early Learning Center: Grade K — 5900 Swope Parkway
Della Lamb Community Center: Grades K-5 — 500 Woodland Ave

Please complete the form below to register your children in the summer program — one completed registration form is required for each child. Fields labeled with an * are required.

Race*

Current Grade Level*

Student's Gender*

Individualized Education Plan (IEP)*

504 Plan*

Student's Current School*

2020-2021 Grade Level*

Site Choice (Choose One)*

Student's T-Shirt Size*

Summer Academic Program Rules and Regulations:

ATTENDANCE: Attendance will be taken each morning. The program is academically designed to discourage "summer learning loss," therefore, a pattern of consistency in attendance is encouraged.
TARDINESS: All students are expected to be in their classrooms when academic instruction begins. Children arriving after 8:15 am will be counted as tardy, three (3) tardies will equal one (1) absence.
LEAVING THE BUILDING: Students are not allowed to leave the building unless they are leaving the school grounds with their parents for the day.
SPECIAL SERVICES: Parents are encouraged to contact the program in the event their student(s) require special accommodations. A determination can be made on how best to support the student(s).
CITIZENSHIP: Students are expected to maintain a wholesome attitude toward learning and to display the utmost respect for the program, staff, environment and one another. The program has zero tolerance for bullying. Any child engaged in this behavior is subject to disciplinary action, including expulsion.
DRESS CODE: Students are expected to dress in the same manner as acceptable during the regular school year.
RULES & REGULATIONS: Students are expected to abide by all the rules and regulations established by the program's code of conduct. Failure to do so will result in disciplinary action.

I attest that my son/daughter:

Has all the necessary documents, including, but not limited to, birth certificate or other proof of parent/guardianship, immunization records and proof of residency, and are on file with the district/school.
Is eligible for summer school and is not currently serving on a long-term suspension or expulsion from any in-state or out-of-state district/school.
Has not been convicted or charged with any of the following crimes: first or second-degree murder; first-degree assault; forcible rape or sodomy; first-degree robbery; distribution of drugs to a minor; first-degree arson; or a Class A felony kidnapping.
Has not attended another summer school program offered by a public school district and/or charter prior to enrolling in the Upper Room Summer Academic Program.

I understand and accept the Upper Room Summer Academic Program Rules and Regulations. I agree that my student will be placed in class(es) according to his/her current school's recommendation. I give my consent for The Upper Room Summer Academic Program to request my child(ren)'s records from any current or previous district/school attended. I understand that if any of the above information is found to be false that my child(ren) will be removed from The Upper Room Summer Academic Program.*

I hereby authorize The Upper Room Summer Academic Program to publish the photographs of my children, and our names, for use in The Upper Room Summer Academic Program's printed publications, website, and social media profiles. I acknowledge that since participation in publications and websites produced by The Upper Room Summer Academic Program is voluntary, neither the minor children nor I will receive financial compensation.*

Photo Consent*

Where did you hear about The Upper Room Summer Academic Program?*

Enroll Now For Our Summer Academic Program!

Please complete the form below to register your children in the summer program — one completed registration form is required for each child. Fields labeled with an * are required.

Summer Academic Program Rules and Regulations:

I attest that my son/daughter:

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