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Summer Cub Care Graphic

L.E.A.D. Academy Summer Cub Care

Registration Form

Please fill out the following form as completely as possible. 

$25 Registration fee and weekly/daily charges may be paid on Gradelink or in person in the main office. 

Student Information

Parent/Guardian Information

Emergency Contact

Authorized Persons for Pickup

Student Health

Does your student have allergies that we should be aware of?
Does your student use either of th following?

Photo/Video Release

I hereby grant L.E.A.D. Academy the right to use any photographed and/or video image of my child to edit such photograph and/or video image in any manner it deems fit. I understand that the photograph and/or video image of me/my child may be used for educational and promotional purposes of L.E.A.D. Academy, and it is not being produced for profit. I hereby release L.E.A.D. Academy, its agents and/or licensees from any and all liability for claims and/or demands arising out of the agreement as set forth above. I will make no monetary or other claim against L.E.A.D. Academy for the use of any photograph and/or video. 

Thanks for submitting!

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