Spring 2025 Registration

Please Choose Which Program(s) the Participant would Like to Attend:
Weekend Ink
Teen Writers' Symposium | @ CSU's Mather Mansion | 6th-12th grade | May 3rd | 11:30am-3pm | $10

Open Mic | @ LEI | 6th-12th grade | Apr 25 | 6:30-8pm | FREE | no registration required
Please select your Weekend Ink program(s) below:

Teen Writers' SymposiumOpen Mic
Evening Ink

Evening programs meet once a week for 6 weeks. Evening programs do not meet on holidays.
Spring: Writers’ Club | VIRTUAL | Wednesdays | Apr 9-May 14 | 6:30-8pm | 5th-12th grades | $10 registration fee
Please select your Evening Ink program(s) below:
Please select your Evening Ink program(s) below:

Writers' ClubDungeons & Dragons, MondaysDungeons & Dragons, WednesdaysHave You Heard? Teen Podcasting
Facing the College Essay

FREE
Please select your college essay workshop dates below:

May 10th

Participant Information
Student Birthdate*

MonthDayYear
Date
Student Pronouns (she/her, he/him, they/them, etc.)
Student School*
Student Grade for the 2023-2024 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?

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 that the individual(s) listed above cannot be reached in an 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

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

YesNo
If anyone other than the parents/guardians listed above will be picking up your child, please enter their full names and phone numbers below:
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

Permissions
Student email which will be used during virtual programs.
example@example.com
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
Freedom of Expression Policy: 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 participants work suggests possible harm to self or others. I have read and consent to the Lake Erie Ink Freedom of Expression policy:*

YesNo
Parent/Guardian Signature*

Clear
Student Signature:*

Clear

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Register for Spring 2025!