Young Scholars Learning Center Admissions Packet
Welcome to Young Scholars Learning Center! We're thrilled you're considering either our summer or afterschool program for your child. We're committed to providing a nurturing and enriching environment where every scholar can thrive. We look forward to partnering with you on your child's educational journey. Please don't hesitate to reach out with any questions as you complete the enrollment process." Please complete this packet with accurate and up-to-date information.
Student's Name
*
First Name
Last Name
Birth Date
*
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Year
Sibling 1
First Name
Last Name
Birth Date
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
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5
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Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
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1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Sibling 2
First Name
Last Name
Birth Date
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a year
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Home Phone Number
*
Format: (000) 000-0000.
Mobile Number
Format: (000) 000-0000.
Primary Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Select Camp shirt size (Student1)
*
Small
Medium
Large
Extra-large
Select Camp shirt size (Sibling 1)
Small
Medium
Large
Extra-large
Select Camp shirt size (Sibling 2)
Small
Medium
Large
Extra-large
Please provide any medical or dietary restrictions any of the students have.
Physician's Name
*
First Name
Last Name
Physician's Phone Number
*
Format: (000) 000-0000.
List all Allergies and or Medical Conditions. Please list all Medications (if any, please provide instructions):
How did you hear about Camp?
Please Select
Email
Facebook
Print Ads
Radio
Referral
School Official
Others
I grant Young Scholars Learning Center permission to use photographs and/or videos of my child for promotional and educational purposes. *Parents/guardians retain the right to revoke this authorization at any time through a written request.
*
Yes
No
Back
Next
School Information
School Currently Attending
Year in School
Please Select
First Grade
2nd Grade
3rd Grade
4thGrade
5th Grade
6th Grade
7th Grade
8th Grade
Back
Next
Family Information
Parent/Guardian's Name
*
First Name
Last Name
Parent/Guardian's Name
First Name
Last Name
Contact Phone Number
*
Format: (000) 000-0000.
E-mail Address
example@example.com
Back
Next
Emergency Contact Information
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Format: (000) 000-0000.
Relationship to Student
*
Back
Next
List all individuals authorized to pick up the student: Name: Relationship to Student: Telephone Number:
*
Name of Second Adult: Relationship: Telephone Number:
*
Name of Third Adult: Relationship: Telephone Number:
To ensure your child's safety, please create a 5-digit release code. This code is essential for anyone on your authorized pick-up list to pick up your child. No code, no release.*
*
Choose the services for your scholar
*
Summer Camp Enrollment ($225 Paid Weekly) (9am-3pm)
Before Care (7:30am-9am) $50
Aftercare (3pm-5:30pm) $50
Afterschool Program(TBA)
Tutoring ($40 Hourly k-8th) Minimum (2) Hours weekly
Early Bird Special ($200 Paid Weekly) This special is until March 30,2026
Payment Due Date: Every Monday/ Payment Method: YSLC Website/ Late Payment Fee: $20.00./Policy regarding non-refundable payments and credit card fees are Found in Student Handbook located on the YSLC website. Do you agree with policy regarding the late payment and payment due dates?
*
Yes
No
Stay Connected: Create Your Account Today!To ensure you receive all crucial information and documents for your scholar—including important updates, payment invoices, and receipts—please take a moment to create an account on our website. This is our primary way of keeping you fully informed! Once your account is set up, you'll also be able to access the Student Handbook and Code of Conduct there.
I agree to create an account
I do not wish to create an account
By checking the box below, I confirm that I have thoroughly read, understood, and agree to adhere to the policies and expectations outlined in the (2026-2027) Young Scholars Learning Center Student Handbook and Code of Conduct.Student Handbook and Code of Conduct
*
I confirm I have reviewed and understand this document.
Please click the link to pay your registration fees. Registration Fee LinkJust a heads up: Your scholar won't be officially enrolled until all fees are paid.
I'll pay the registration fees when I submit my camp fees.
I'll pay today!
Thank you for completing your enrollment packet for Young Scholars Learning Center! We're thrilled by your interest and will be in touch very soon with the next steps for your scholar.
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