2025 Lone Star Leadership Academy Student Application

2025 Lone Star Leadership Academy Student Application
Section 1: Preliminary Information
*It is recommended that you complete this application on a desktop/laptop device rather than a phone or tablet.*
Before beginning, make sure you have the following information:
- Name of the educator who nominated your student, if this is their first time to attend
- Contact information for an emergency contact (not a parent)
- Your student's t-shirt size
- Your student's most recent grade report (picture or electronic file)
- Your student's health insurance ID card (front and back, picture or electronic file)
- Credit/Debit card OR checking account and routing numbers
Before proceeding, please note that Education in Action does not provide transportation to camp on the first day or back home on the last day.

Parents/Guardians are responsible for providing transportation to and from the following locations:

Dallas/Fort Worth Program: Keller, TX

Austin/San Antonio Program: Wimberley, TX

Houston/Galveston Program: Crosby, TX

Full details for student drop-off and pick-up will be provided in a welcome packet mailed to you upon registration.
Please initial to confirm that you understand that Education in Action does not provide transportation to camp on the first day or back home on the last day.*
Initials
Has your student previously attended a Lone Star Leadership Academy program?*

NoYes
Has your student been nominated by an educator for the Lone Star Leadership Academy?*

YesNo
Before you can proceed, you will need to request a nomination from any teacher, counselor, or principal.

After an educator has submitted the nomination, you may return and complete the camp application.

Here's a sample request message that you can copy and paste into an email:

Dear (Mr./Mrs./Ms./Dr.) (Last Name),

(Student Name) is applying to attend a Lone Star Leadership Academy camp through Education in Action this summer. In order to participate, (he/she) must first be nominated by an educator. If you are willing to nominate (him/her), you can do so online at www.educationinaction.org/nominate-leaders. It should only take a few minutes of your time.

You can learn more about the Lone Star Leadership Academy online at www.educationinaction.org/lone-star-leadership-academy, or if you have any questions you can contact Education in Action directly at 817-562-4957 (menu option 3) or admissions@educationinactino.org.

Thank you,

(Your Name)
Please enter the name of the educator who nominated your student.*

First NameLast Name
Are you applying for a Donated Lone Star Leadership Academy Scholarship ($100 scholarship for students who qualify for free/reduced-price meals at school)?*

YesNo
Please Submit a Paper Application
We are currently unable to accept online applications for students who are applying for the Donated Lone Star Leadership Academy scholarship. Please submit a paper application, available here.

If you have any questions, please contact us at 817-562-4957 (menu option 3) or admissions@educationinaction.org.

Thank you! We look forward to receiving your application!

Section 3: Academic Information
School

Please provide the following information for the 2024-2025 school year.
Grade Level*
School Name*
School District*
For private or charter schools, enter "private" or "charter."
Grade Average Verification

Grade reports must indicate a B/85 or higher overall grade average and a "satisfactory" or equivalent conduct grade. Students with a conduct grade below "satisfactory" or equivalent will be asked to provide an additional letter of recommendation from an educator.
Please upload a copy of your student's most recent grade report.*

Browse Files

Cancelof
School/Community Activities

Please list two recent school/community activities. These are anything your student participates in outside of regular classroom instruction. Examples include participation in sports teams, scouting, after-school clubs, volunteer work, music lessons, dance classes, tutoring other students, religious activities, contests, etc. You may also include recent awards or honors, excluding Honor Roll.
1.*
2.*

How did you hear about the Lone Star Leadership Academy?*

My student was nominated this school year.My student was nominated during a previous school year.From a sibling/friend.Internet search.Other
Section 6: Additional Information
T-Shirt Size:*
Sandwich Choice for One Meal:*
Will your student require all meals to be vegetarian?*
Will your student require all meals to be gluten-free?*

Section 7: Refund and Fees Policy
The completed application must be submitted no later than the Application Deadline and include a credit card/debit card payment, payment authorization form, or a check/money order made payable to Education in Action. If a payment is denied, the postmark or submission date of the payment sent will be voided. For example, if a payment is postmarked or submitted by April 26, 2025 but the payment is denied, the tuition rate will increase from $1,295.00 to $1,395.00 and the remaining balance will be due 15 calendar days prior to the student’s camp session start date. If the $300.00 non-refundable deposit has been paid and the application processed, the deposit amount will not be refunded. After receiving a welcome packet, a $15.00 replacement fee will be required to obtain another copy.

Student and Parent/Legal Guardian should note that if, after Education in Action has accepted the student’s application, the Parent/Legal Guardian cancels the student’s participation in the Lone Star Leadership Academy, a refund of the tuition already paid minus the $300.00 deposit will be issued provided that notification of cancellation and request for refund is received in writing by Education in Action no later than April 26, 2025. No refund will be made for tuition if the notice of cancellation is received after April 26, 2025; this includes, but is not limited to, cancellation due to illness/injury, mental illness, inclement weather, and/or lack of transportation.

Please initial to confirm that you understand the refund policy:   Initials*

All sponsorship payments must be postmarked to Education in Action no later than 15 calendar days prior to the student’s camp session start date in order to receive reimbursement; no reimbursements for sponsorships will be issued for payments postmarked within 15 calendar days of the student's camp session start date.

Student and Parent/Legal Guardian should note that all applications are processed strictly in order of receipt and that applications may exceed available space. This is an application for participation and enrollment is contingent on final approval by Education in Action, with whom sole discretion resides. If the application is denied, the application and all monies included will be returned. Education in Action reserves the right to cancel a program before the student’s departure from home, in which case any monies paid to Education in Action will be refunded. Education in Action reserves the right to change or modify a program's itinerary before or after a program is scheduled to begin.

Student and Parent/Legal Guardian should note that if, after Education in Action has accepted the student’s application, Parent/Legal Guardian changes the student's scheduled camp session for any reason, a $65.00 administrative fee will be charged if the change occurs after April 26, 2025. Camp session changes may be requested up until two Fridays (nine calendar days) prior to the originally scheduled camp session start date and will be honored on a space available basis. Camp session change requests must be provided to Education in Action in writing and must be submitted with the $65.00 payment (if applicable based on date).

Please initial to confirm that you understand the camp session change fee:   Initials*

Student and Parent/Legal Guardian should note that a fee of $65.00 will be assessed if the student has not been picked up within 15 minutes of the published pick-up time on the final day of the program.

Please initial to confirm that you understand the late pick-up fee:    Initials*

In the event that a program must be rescheduled for any of the following causes: Acts of God or public enemies, civil war, insurrection or riot, fire, flood, explosion, earthquake, serious accident, public health risk, strike, labor dispute, or any cause beyond Education in Action’s reasonable control, the above cancellation policy remains in effect with the exception that the non-refundable deposit will remain on the student’s account for a future program. If the student does not enroll in a future program, the deposit remains non-refundable.

Parent/Guardian Signature*

Student Signature*

Section 8: Emergency Medical Authorization
I do hereby request, authorize, and give permission to Education in Action, or its duly authorized representative, to act on my behalf and in my stead, should my son/daughter complain of being ill, be injured, or require emergency or other medical treatment, including hospitalization, during the Lone Star Leadership Academy. I understand that in the event that my son/daughter complains of being ill, or is injured during the Lone Star Leadership Academy, he/she will be taken to a hospital emergency room and examined by an emergency room physician. If the physician determines that my son/daughter does not require hospitalization but should not continue as a program participant, at the written direction of the physician, my son/daughter will be sent home promptly. I expressly stipulate and agree that I will be solely responsible for all expenses incurred and will release and hold harmless Education in Action, its officers, directors, employees, administrators, agents, successors, and assigns from all claims, demands, damages, actions, or causes of action, present or future, whether known, anticipated or unanticipated, and resulting from, rising out of, or incident to Education in Action’s actions pursuant to this authorization.

I understand that I will be required to pick up my child in a timely manner in the event that he/she becomes injured or ill and is unable to continue participation in the Lone Star Leadership Academy.

Parent/Guardian Signature*

Section 9: Release and Agreement to Program Rules
The program participant and Parent/Legal Guardian agree to the following terms:

In consideration of being accepted as a participant in the Lone Star Leadership Academy, the undersigned Student and undersigned Parent/ Legal Guardian each hereby release and hold harmless Education in Action and its employees and agents from any liability arising out of my participation in said program, and each further agrees to reimburse Education in Action or its employees and agents for any loss, damage, or costs they may incur during said program and that are caused by my participation. Education in Action shall not be liable or responsible for any injury, loss, damage, or delay resulting from any act or neglect of any person or company whose services are retained by Education in Action for the benefit of program participants, including but not limited to, accommodations, restaurants, or transportation companies. Furthermore, Education in Action cannot be held responsible for any act, error, or omission on the part of any program participant or participants.

I understand that the Lone Star Leadership Academy is a professional program and as such demands the highest standards of behavior. I will conduct myself in a manner that will contribute to a sense of community among all participants and foster an atmosphere of mutual respect. Any student possessing or using drugs or alcohol, violating curfew, leaving the activities of the program, or behaving in any manner inconsistent with Education in Action standards or local, state, or federal statutes will be immediately dismissed from the program. Education in Action follows a zero tolerance policy; there are no second chances. If a student is dismissed from the program for disciplinary reasons or upon advice of a medical doctor, the student’s Parent/Legal Guardian will assume all financial responsibility for returning the student home. No tuition refund will be made.

I agree my participation entitles me to the standard arrangements and activities offered and/or scheduled by Education in Action, including, but not limited to, housing, meals, charter bus transportation during the program, and educational materials, and that all special arrangements and/or requirements must be independently provided and/or that I must bear the cost of any and all special arrangements and/or requirements outside of the standard activities and arrangements offered by Education in Action.

For the health and safety of every participating student, Education in Action reserves the right during the entire program to conduct dormitory inspections to ensure student compliance with the stated rules and regulations. While student phone calls are not scheduled throughout the program, parent updates will be provided on Education in Action’s website during the program week. Cell phones and other electronic devices (i.e. smart watches, Bluetooth tracking devices such as Air Tags, digital music players, gaming devices, alarm clocks, laser pointers etc.) are not permitted on the program. This includes the use of cell phones for the sole purpose of taking photos. Digital cameras are permitted. Education in Action posts daily photo updates for parents throughout the program.

Please initial to confirm that you understand the cell phone/electronics policy:   Initials*

Education in Action reserves the right to use, in any or all publications, promotional materials and publicity, basic student information (e.g. name, school, hometown) and further reserves the right to use in all publications, promotional materials, and publicity any photograph, audiotape, videotape, or film in which the student may appear.

Parent/Guardian Signature*

Student Signature*

Section 10: Authorization
Each of the undersigned has carefully read the complete application including the Refund and Fees Policy, Emergency Medical Authorization, and Release and Agreement to Program Rules (including the cell phone and electronics policy), and with full understanding of the terms and refund policy, consents to the participation of the undersigned student in accordance with the standards, rules, and regulations of Education in Action.

Parent/Guardian Signature*

Student Signature*

2025 Lone Star Leadership Academy Student Application

Section 1: Preliminary Information

Please Submit a Paper Application

Section 2: General Contact Information

Student

Parent/Guardian 1

Parent/Guardian 2

Additional Emergency Contact

Consent to Release Information

Section 3: Academic Information

School

Grade Average Verification

School/Community Activities

Section 4: Select a Camp Session

Select Location

Select Week

Section 5: Health Information

Temporary Insurance Information

Acknowledgement

Health Insurance

Student Health Information

Section 6: Additional Information

Section 7: Refund and Fees Policy

Section 8: Emergency Medical Authorization

Section 9: Release and Agreement to Program Rules

Section 10: Authorization

Section 11: Tuition and Deadlines

Tuition

Optional Items