READ2LEAD Registration 2026-2027

FIELD TRIP PERMISSION

Your child may be invited on a field trip as part of the MDC Read2Lead program. Before a field trip, you will receive detailed information about the proposed excursion. By signing below, you give the READ2LEAD program permission to transport your child to and from any field trip opportunity.
Student's T-shirt Size
For field trips, we would like to purchase your student a T-shirt!
Signature
Date
How did you hear about our program?
If a specific person referred you, please mention their name.
AUTHORIZATION TO PRODUCE AND USE AUDIOVISUAL MATERIALS

I hereby voluntarily and without compensation authorize the READ2LEAD program to produce photographs, movies, videotapes, DVDs, and audiotapes of the student named below. The images may appear online on the program's website or social media pages. This authorization is given on the condition that the material taken or produced will be used for community education and program promotion. I understand that the READ2LEAD program and its employees will not used the materials for compensation. I understand that this grant of permission shall only be revoked by written instrument delivered to the site coordinator of the READ2LEAD program prior to the release of any material. This consent shall remain in effect unless revoked.
Student Name
Parent/Guardian Name
Signature
Date
Student Behavior and Attendance Policy

Students are expected to follow the behavioral expectations set by the READ2LEAD Program. If student(s) cannot follow these behavioral guidelines, the program will contact their parent/guardian and may ask the student(s) to leave the MDC READ2LEAD program for the remainder of the day. Repeated or severe violations of the behavioral expectations may result in the student not being able to participate in the READ2LEAD program. Parents should also plan for student to be in attendance for at least one (1) hour after school each day they attend. Continual (3 or more) unexplained early pick ups - before 4:30pm - will result in the student's spot being forfeited to another student on the waitlist. In addition, we encourage parents/guardians to allow students to stay for the duration of the program (3:30-6:30pm). Parents/Guardians/Authorized Pick Up Persons are asked to please notify us if they are running later than 6:35pm. Any student who is continually (3 or more times) picked up after 6:45pm may result in the student not being able to participate in the READ2LEAD program.
Signature
Date

TRANSPORATION

By signing below, you give the READ2LEAD program (MEMPHIS DREAM CENTER and THE LIFE CHURCH) permission to transport your child to the program or as agreed upon by the above transportation plan.

In the event my child will be absent and will not be transported as outlined above, I agree to notify the site coordinator of the READ2LEAD program.
Please select one of the following for Student Drop Off
AUTHORIZED PICK UP LIST

The child may be released to the guardian signing this agreement or to the following individuals:

Name/Address/Phone Number (include complete street address, city, state and zip code)
Individual 1
Full Name
Address
Individual 1 Phone
Phone Number
Relation
Individual 2
Full Name
Address
Individual 2 Phone
Phone Number
Relation
Individual 3
Full Name
Address
Individual 3 Phone
Phone Number
Relation
Transportation Permission

By signing below, you give the Zele' program (MEMPHIS DREAM CENTER and THE LIFE CHURCH) permission to transport your child to the program or as agreed upon by the above transportation plan.

In the event my child will be absent and will not be transported as outlined above, I agree to notify the site coordinator of the READ2LEAD program.
Signature
Date

Participant & Parent Agreement
MDC READ 2 LEAD Program believes that children are to be respected, encouraged and protected AT ALL TIMES. MDC is committed to partnering with parents in providing this care. MDC desires to aid in the succesful development of each child according to their unique abilities and personality.

In line with this expecttion , guidance and discipline procedures shall involve verbal redirection, time out, encouragement and modeling of appropriate behavior.

Here, listed are the steps of disciplinary procedures we follow:

1. Student receives verbal warning from staff/volunteer

2. Read 2 Lead Director talks to student.

3. The Director will meet with the parent about student's behavior.

4. If behavior continues, a one week suspension will be administered

5. Parent/Student required to attend a re-entry meeting with the Program Coordinator.

Severe behavior infractions may result in the child's immediate suspension or termination from MDC Read 2 Lead.

( Severe behavior includes but not limited to: Physical Agression,bullying, harassment, Intimidation, or threats, leaving the program without permission, theft, inappropriate sexual behavior or harassment, any behavior that places the student, staff members or volunters at risk)
Parent/Guardian Acknowledgment & Agreement
By signing below, I acknowledge that I have read and understand the Read 2 Lead Program Expectations and Behavior Policy. I have discussed these expectations with my child and understand that I am responsible for partnering with Read 2 Lead staff to encourage respectful, safe, and positive behavior.

I understand that:

My child is expected to follow all program rules and expectations.
I will support the program’s behavior expectations and work collaboratively with staff to address any concerns.
I will respond promptly to communication regarding my child’s behavior or well-being.
Failure to follow program expectations may result in disciplinary action, including suspension or dismissal from the program when appropriate.
I understand that the Read 2 Lead Program reserves the right to make decisions regarding participant safety and continued enrollment when behavior significantly disrupts the learning environment or places others at risk.
Signature
Should be Empty:

READ2LEAD ASP Enrollment Form

Participant & Parent Agreement