2026 She Elevates Academy Registration

2026 Academy Registration

July 13-17, 2026 from 8:00 am - 3:30 pm | Graduation: July 18 Location: One Center, Canton | Registration Deadline: June 12, 2026
Student Name*

First NameLast Name
Student Primary Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Date of Birth*

MonthDayYear
Date
Student Age*
American Indian or Alaska NativeAsianBlack or African AmericanHispanicMulti-RacialOtherPacific Islander/Native HawaiianWhite/Caucasian
Where did you hear about She Elevates Academy?*
Why does your student want to attend She Elevates Academy?*
YesNo
School District*
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Relationship to Student*
Parent/Guardian Email*
Same email used for your Academy application
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Emergency Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Emergency Contact*
Alternate Emergency Contact Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Alternate Emergency Contact Address*
Does your student have any medical conditions or special needs we should be made aware of?*
Student's Primary Care Physician Name and Address*
Student Primary Care Physician Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Student T-Shirt Size*
Service BusinessProduct BusinessCommunity Project
Student Email
Optional-By submitting this form, you give us permission to communicate with your registrant by email if this field is populated.
Student Mobile Phone Number
Optional -By submitting this form, you give us permission to communicate with your registrant by text if this field is populated.
Head Shot Upload*

Please upload a head shot of your registrant for check-in/check-out.
Cancelof
30% Very Low50% Very Low60% Low Income80% Low IncomeDoes Not Apply
Because this program is funded to serve youth at no cost, no-shows who do not notify us may jeopardize their eligibility for future programs. If your child cannot attend after you register, please notify us as soon as possible — preferably at least 14 days in advance so we can make the spot available to youth on the waiting list — by emailing info@sheelevates.org or calling 877-550-1751. Thank you!
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2026 Academy Registration