Fall 2025 Registration

Register for Fall 2025!
Thank you for your interest in Lake Erie Ink's creative expression programs for youth.

The information we collect in this registration form will be saved for future registrations through May 2026.

Payment for workshops can be made via the PayPal checkout at the end of this form, or by check sent to Lake Erie Ink: 2108 S Taylor Rd., Cleveland Heights, OH 44118. Partial scholarships are available for all programs - request a scholarship at the end of this form.

If we cancel a class session due to low enrollment, you will receive a full refund. However, we cannot refund money for a session that you are not able to attend, or that is cancelled due to Covid-19. We can give you credit for another session.

You will receive program details and zoom links for virtual workshops a week prior to the session via email. If you have any questions, please email staff@lakeerieink.org or call 216-320-4757. Thank you!
Parent/Guardian Email Address*
example@example.com
Child Name*

First NameLast Name

Please Choose Which Program the Participant would Like to Attend
Evening Ink

Virtual Writers' Club | Wednesdays | Oct 8-Dec 3 | 6:30-8pm | 6th-12th grade | $100

Story Games: Dungeons & Dragons

Mondays Session 1 | Sep 15-Oct 20 | 6-8pm | 9th-12th grade | $120

Wednesdays Session 1 | Sep 17-Oct 22 | 6-8pm | 5th-8th grade | $120

Mondays Session 2 | Oct 27-Dec 8 | 6-8pm | 9th-12th grade | $120

Wednesdays Session 2 | Oct 29-Dec 10 | 6-8pm | 5th-8th grade | $120

Story Games: Monster of the Week

Session 1 | Fridays | Sep 19-Oct 24 | 6-8pm | 7th-12th grade | $120

Session 2 | Fridays | Nov 7-Dec 19 | 6-8pm | 7th-12th grade | $120

Story Games: Mausritter

Session 1 | Tuesdays | Sep 16-Oct 21 | 4-6pm | 3rd-5th grade | $120

Session 2 | Tuesdays | Oct 28-Dec 9 | 4-6pm | 3rd-5th grade | $120

Mausritter session 1 is cancelled.
Select your Evening Ink(s) below:
Creative Play Days

Leaf and Nature Art Collage - This program is cancelled.

Paper Bag Gratitude Journal | Tuesday | Nov 4 | 9:30am-12:30pm | 2nd-5th grade | $25

Cozy Creature Puppets | Saturday | Nov 15 | 9:30am-12:30pm | 2nd-5th grade | $25

Winter Solstice Lantern Workshop | Monday | Dec 22 | 9:30am-12:30pm | 2nd-5th grade | $25

Memory Box Workshop | Monday | Dec 29 | 9:30am-12:30pm | 2nd-5th grade | $25
Select your Creative Play Day(s) below:
Weekend Ink

Teen Writers' Symposium | Nov 8 | 11am-3pm | 6th-12th grade | $10 | @ CSU's Mather Mansion

Inside Out | Oct 18 & Nov 22 | 3-5pm | 6th-12th grade | $10 each
Select your Weekend Ink(s) below:
Facing the College Essay Workshops

for 9th-12th grade | $10 per workshop

Virtual: Sep 11, Oct 16, Nov 6 | 6:30-8pm

In Person: Aug 16, Sep 27, Oct 11, Dec 13 | 11am-12:30pm
Select your College Essay Workshop(s) below:
Open Studios

6th-12th grade | 2-5pm | @ Lake Erie Ink | Free!

Thursday, Oct 23 | Saturday, Nov 15 | Monday, Dec 22 | Monday, Dec 29
Select your Open Studio date(s) below:
Creative Neighborhood Days

Intergenerational Creative Workshops - All ages welcome!

Storytelling Through Song | Sunday, Sep 21 | 1-3pm | FREE

Creepy Cinema Matinee | Sunday, Oct 26 | 1-3pm | FREE

Cards and Hot Cocoa! | Sunday, Dec 14 | 1-3pm | FREE
Select your Creative Neighborhood Day(s) below:

Have you registered for a program since June 2025?*

YesNo

Has any of your information changed since then?*

YesNo

Participant Information
Student Birthdate*

MonthDayYear
Date
Student Pronouns (she/her, he/him, they/them, etc.)
Student School*
Student Grade for the 2024-25 School Year*
Student Home Address *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Demographic Information

The following demographic questions help Lake Erie Ink report and apply to funders upon request. All information will remain confidential.
What is your child's ethnicity?*

AsianBiracialBlack or African AmericanHispanic or LatinoNative American or AlaskanPacific Islander or HawaiianWhite or CaucasianPrefer not to answerOther
What is your child's first language, if not English?

Parent/Guardian and Emergency Contact Information
Parent/Guardian Full Name*

First NameLast Name
Parent/Guardian Cell Phone*
Please enter a valid phone number.
Parent/Guardian Relationship to Child
Parent/Guardian Email*
example@example.com
Second Parent/Guardian Full Name

First NameLast Name
Second Parent/Guardian Relationship to Child
Second Parent/Guardian Cell Phone
Please enter a valid phone number.
Second Parent/Guardian Email
example@example.com
Alternate Emergency Contact:

First NameLast Name
Alternate Emergency Contact Phone Number:
Please enter a valid phone number.
Alternate Emergency Contact Relationship to Student:

Learning & Medical Concerns
Please describe any special learning concerns you might have for your child:
Please describe any medical or health concerns (i.e. allergies, asthma, diabetes, etc.):
In the event of a medical emergency, I hereby give my consent for emergency medical treatment by a licensed professional and the transfer of my child to a local hospital.*

YesNo
Lake Erie Ink will always call 911 in the event of a medical emergency, but we will alert first responders and medical personnel if your child does not have consent for medical treatment.

Pickup Information
Does your child have permission to leave on their own (walk, bike, drive, etc.) at the conclusion of the program?*

YesNo
Please list the names and numbers of anyone who has permission to pick up your child (other than the parents/guardians listed above):
Liability Release: I understand and agree that Lake Erie Ink: A Writing Space for Youth (hereafter “LEI”) is not responsible for supervising my child or for my child’s safety after the end of the program, and that neither LEI nor any of its staff members is liable for any physical or emotional harm to my child, caused by my child’s negligence or by the negligence, intentional act or criminal act of a third party, nor for any property or damage or loss caused by my child.*

I understand and agree with the above.

Permissions
Student email which will be used during virtual programs.*
If your child will not be using their email, please enter the preferred contact email for information about this program.
Please check the box below confirming that you understand that Lake Erie Ink teachers are collecting emails to be able to communicate with your child about the workshops using online means (email or Zoom platform). If you have any questions or concerns please email: cbailey@lakeerieink.org*

YesNo
I give permission to Lake Erie Ink to photograph/videotape my child while participating in program activities. These photos or videos may be used to promote Lake Erie Ink programs.*

YesNo
I give permission for Lake Erie Ink: a writing space for youth to publish my student’s work in any Lake Erie Ink publication, including our student anthologies, website, social media, blog, vlog, or podcast, using my first name, last initial, and age/grade.*

YesNo
Participant Guidelines

Please review the guidelines below with your child.

1. Participants respect others at Lake Erie Ink, so that everyone is able to grow and take creative risks as writers.

2. Participants will respect and listen to one another and the LEI staff and volunteers. Bullying will not be tolerated. This includes:
- physical bullying: hurting someone or threatening to hurt someone
- verbal bullying: name calling, teasing, and insults
- relationship bullying: such as refusing to talk to someone, talking unkindly about someone, or trying to get someone to do something they don't want to do
3. Participants will inform staff if they are experiencing a problem at any time.

4. Participants will respect the property of others, including the Lake Erie Ink facility, the supplies, the private property and the creative work of other participants, staff, and volunteers.

5. Participants will remain in the areas designated for Lake Erie Ink and follow dismissal procedures.

6. Participants will keep personal items that might cause distraction or disturbance inside of their backpack. Lake Erie Ink will not be held responsible for the theft or damage done to any personal items, including cell phones, laptops, or electronic games.

7. Freedom of expression: Lake Erie Ink believes in freedom of speech and respects the right of all participants to express themselves honestly and creatively. However, we reserve the right to contact parents/guardians/school authorities if we feel the content of a participant's work suggests possible harm to self or others.

Sign your name below to show that you have read and understood these guidelines and agree to follow them while you are a participant in Lake Erie Ink programs.
Parent/Guardian Signature*

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Student Signature:*

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How did you hear about this program? Check all that apply.*

Social MediaSchool/TeacherLake Erie Ink EmailFlyerMail from Lake Erie InkCurrent ParticipantGoogle/Web SearchOther
Where did you see the flyer?
Teacher/School name:
Other:
Newsletter

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Register for Fall 2025!

Please Choose Which Program the Participant would Like to Attend

Participant Information

Demographic Information

Parent/Guardian and Emergency Contact Information

Learning & Medical Concerns

Pickup Information

Permissions

Payment

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