Enrollment From

Enrollment From

Pre-register for the BTG Summer Leadership & Life Skills Program (June 1 – July 31, 2026; ages 7–16). This strengths-based form is open to all youth, including foster youth, and includes program interest, support needs, and alternate contact information. Review the program dates and lunch policy before submitting.
Parent/Guardian Information
Parent/Guardian Full Name

First NameMiddle NameLast Name
Relationship to Child
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Child Information
Child Name
Child Age Group
What grade did your child complete during the 2025–2026 school year?
School Type
School Name
How would you describe your child’s school year overall?
Child Strengths, Interests & Growth
What life skills, leadership qualities, or personal growth areas would you love to see your child continue developing this summer?
Confidence; Communication skills; Responsibility; Teamwork; Leadership; Emotional regulation; Social skills; Independence; Problem-solving; Time management
What are your child’s interests or favorite activities?

Other
What are some things you would love for us to know about your child?
Personality traits; Learning style; Interests; Motivations; Communication style; Things they enjoy; Ways they thrive in group settings
What experiences, goals, or positive outcomes would you love for your child to gain through this summer program?
Building confidence; Making new friends; Learning leadership skills; Staying active and engaged; Exploring new interests; Improving communication; Developing responsibility; Strengthening teamwork skills
What strengths, talents, gifts, or positive qualities does your child bring into a group environment?
Creativity; Leadership; Athletics; Helping others; Art; Technology; Communication; Music; Problem-solving; Academic strengths
Support & Accessibility
Does your child currently have any of the following support plans or services?
Does your child require 1:1 support or supervision?
Does your child have any allergies we should be aware of?
If yes, please describe the allergies and any related considerations.
Does your child have transportation to the program?
Preferred Program Location
Program Option Interested In
Meal Support & Accessibility
The BTG Summer Leadership Program currently requires children to bring a daily lunch. However, BTG believes every child should have access to a safe, engaging, and enriching summer experience, and we do not want meal access to become a barrier to participation for families.
Would additional meal support information or resources help your family participate successfully in the program?
Would you like information regarding:
Referral Information
Were you referred to BTG?
If yes, who referred you?
How did you hear about BTG?

Other
Alternate Contact
If we are unable to reach you regarding enrollment or registration completion, who else may we contact?
Alternate Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Child
Sibling Information
One pre-registration form must be completed per child.
Have you completed a separate form for a sibling?
If yes, list sibling name(s).
How will program costs most likely be covered?
Payment & Pre-Registration
A $15 Enrollment Deposit (Applied Toward Tuition) is required to reserve placement consideration for the BTG Summer Leadership & Life Skills Program.

This non-refundable deposit helps support enrollment processing, staffing preparation, and program planning.

If accepted into the program, the deposit will be applied toward registration or tuition costs.

If BTG is unable to accommodate placement for your child, the deposit will be refunded.
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Enrollment Deposit
$15.00 Quantity

Total

$0.00
I understand this $15 Enrollment Deposit (Applied Toward Tuition) is non‑refundable unless BTG cannot accommodate placement.
I understand this $15 Space‑Holding Deposit is non‑refundable unless BTG cannot accommodate placement.
Payment Transaction ID
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Enrollment From

Parent/Guardian Information

Child Information

Child Strengths, Interests & Growth

Support & Accessibility

Meal Support & Accessibility

Referral Information

Alternate Contact

Sibling Information

Payment & Pre-Registration

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