YSLC Admission Packet

School Information
School Currently Attending
Year in School

Family Information
Parent/Guardian's Name

First NameLast Name
Parent/Guardian's Name

First NameLast Name
Contact Phone Number
Format: (000) 000-0000.
E-mail Address
example@example.com

Emergency Contact Information
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Format: (000) 000-0000.
Relationship to Student

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:
Payment Due Date: Every Sunday/ Payment Method: YSLC Payment Link/ 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?
Summer Camp Attendance &Camp Billing Policy: Please note that if a scholar attends camp for three (3) or more days within a single week, the full weekly tuition fee will be charged. No pro-rated rates or discounts will apply for partial weeks meeting or exceeding this three-day threshold. Do you understand and agree with the policy regarding the Attendance and Billing Policy?
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.
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
A Registration Fee Link will be emailed to you once form submitted. Just a heads up: Your scholar won't be officially enrolled until all registration fees are paid.
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.
Date

MonthDayYear
Date
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.*
Should be Empty:

******2026 Academic Step Up Camp: Summer Enrollment Packet

School Information

Family Information

Emergency Contact Information