Workshop Registration


Summer Registration

Student Information

Student's Gender Pronouns *
(check any that apply to your identity)
00/00/0000
During summer, this refers to the grade student will be entering.

Camp Information

Schedule Availability - Group Session *
We will try to accommodate individual schedules as much as possible, please indicate which daily sessions would work best for your Student.
Schedule Availability - Individual Sessions *
We will try to accommodate individual schedules as much as possible, please indicate which daily sessions would work best for your Student.

Access Information

Since programs will be entirely virtual, Students will need consistent access to a device that can connect to the online classroom site Moodle (such as a computer, tablet, or phone) and will need to be able to comfortably type their work (computer or tablet recommended). Will your Student need to borrow a device? *
Does student need assistance to access a consistent internet connection? *

Parent/Guardian 1 Information

Is Parent/Guardian 1 the student's primary residence? *
(000) 000-0000
Please provide an email you use regularly.

Parent 2 Information

Is Parent/Guardian 2 the student's primary residence?
(000) 000-0000

Emergency Information

In the event of emergency, Parents/Guardians will be contacted FIRST. Please provide a NON-Parent/Guardian Emergency Contact
In the event of emergency, Parents/Guardians will be contacted FIRST. Please provide a NON-Parent/Guardian Emergency Contact
(000) 000-0000

Other Information

Please let us know of any Health information that we may need to be aware of while engaged with your student.
RAWK involves working in large and small groups, one-on-one interactions, giving and receiving feedback, reading aloud, and active listening. Please provide us with any special information you feel would help us create a safe and supportive environment for your student.
Media Release *
I permit Read and Write Kalamazoo to take photographs, audio, and video recording of my student for the explicit purpose of chronicling, promoting, and celebrating the RAWK program. I understand that any media taken of my student taken during RAWK programming will not be used by anyone not affiliated with Read and Write Kalamazoo.
Reserve My Spot *
There are a limited number of spots available in each workshop. By completing this registration a spot will be reserved. If the workshop is already full, this registration will place you on the Wait List.
How did you hear about this workshop?

Data Collection & Reporting

We strive to serve our diverse community. Please share more about your family to help us assess and improve our community connection as well as report information anonymously to funders. This information will be kept completely confidential.
Does Household qualify for Free or Reduced Lunch?