Five Star Life - Summer Learning Labs

Si necesita solicitar este formulario de registro en español, por favor envíe su solicitud por correo electrónico a kstory@fivestarlife.org.

This opportunity is open to Elkhart Community School Students who will be entering 6th grade in the 2026-2027 school year. Slots are limited. Register today!

Five Star Life will be a Summer Learning Labs site in 2026. Each student who registers will be at Summit for 25 consecutive week days (M-F) for Summer Learning Labs academic instructional time and Five Star Life Innovative Learning programming, designed to help students enjoy a fun, engaging Summer Learning experience. Innovative Learning program activities may include, but are not limited to: nature education courses, boating, fishing, arts, rockwall, high ropes course, archery, hatchet throwing, team building, gardening and agriculture, equine and horsemanship, blacksmithing, skilled trades courses, and more!

Cost: FREE!!

Meals: Provided

Dates: June 15 - July 17; Every Day, Monday - Friday

Time: 8:30-4:30

Address: Summit - 14260 US-12, Union, MI 49130

Daily Schedule:

8:00 - Load bus at central transportation site (TBD) and head to Summit (If utilizing central bussing transportation)
8:30 - Arrival at Summit (Via central bussing transportation OR parent drop-off)
8:30-9:00 - Welcome and Introduction
9:00-11:30 - Summer Learning Labs Academic Instructional Time
11:30-12:00 - Lunch
12:00-4:30 - Five Star Life Innovative Learning Program Activities
4:30 - Departure from Summit (Via central bussing transportation OR parent pickup)
5:00 - Arrival back to central transportation site (TBD) for pickup (If utilizing central bussing transportation)

Transportation:

Parents may choose to drop off and pick up students at Summit, or to utilize transportation from a central location with Elkhart Community Schools
Dropoff and Pickup Times at Summit - 8:30 / 4:30
Dropoff and Pickup Times at Central Bussing Location (Site for bussing TBD) - 8:00 / 5:00

Student First Name (No Nicknames)*

Student Last Name*

Student's Primary Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student's Residence Zip Code*

Postal / Zip Code Number

Student's Date of Birth*

Student's Grade for 2025-2026 School Year*

Student's Grade for 2026-2027 School Year*

Student's Gender*

Student's Ethnicity*

Has your child ever had an Individualized Education Plan (IEP) or a 504 Plan? (Student’s Special Education Status)*

Has your child ever had an Individualized Learning Plan (ILP) ?

OPTIONAL TO ANSWER

What is the primary language spoken at home?*

Does your child qualify for free or reduced-price lunch?*

What School will your Student will be attending for the 2026-2027 school year?*

Did your Student receive tutoring through the Indiana Learns program?*

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Phone Number*

Format: (000) 000-0000.

Parent/Guardian E-mail (this is used to send updates with schedules, events and curriculum)*

Parent/Guardian Address (Primary Residence)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact Name (Other Than Parent/Guardian Listed Above)*

First NameLast Name

Emergency Contact Relation to Student*

Emergency Contact Number*

Format: (000) 000-0000.

NOTE: All PARTICIPANTS must have an up-to-date signed Health History Form as well as Assumption of Risk, Liability Release, Indemnity Agreement, Picture and Video Waiver and Release to participate in any leadership experience at Summit.

PLEASE READ AND ANSWER THE QUESTIONS BELOW: This form is intended to remind leaders and participants of the seriousness of attempting adventure activities with an old preexisting injury, a heart condition, or other condition which might be aggravated by the event. Please connect with a Summit facilitator if you need to share any additional and pertinent information.

YesNo

Explain.

YesNo

Explain.

YesNo

Explain.

YesNo

Explain.

YesNo

Explain.

YesNo

Explain.

YesNo

Explain.

LowMediumHigh

Please include any additional information that you feel is relevant.

YesNo

Please include any additional information that you feel is relevant.

YesNo

Please include any additional information that you feel is relevant.

Parent/Guardian Signature*

Please note: dates/programs are subject to change based on enrollment and availability.

Questions? Call us at 574.266.4038 or email us at events@fivestarlife.org

Summer Innovative Learning

Student Information

Parent/Guardian Information

Health History

Emergency Medical Release

Liability Release

Data Release

Emergency Contact Authorization