Summer
Enrichment Registration

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This field is for validation purposes and should be left unchanged.

Note: This form is for current students of Glenwood Academy only. If your child does not currently attend Glenwood Academy, please contact Maya Smith at [email protected].

Student's Name(Required)

First Last

Student Date of Birth(Required)

Rising Grade: (2026-2027)(Required)

What grade will your student be in for the 2026-2027 School Year?

T-Shirt Size

Please indicate Youth Size or Adult Size. Example: Adult Size Small

Parent/Guardian Name(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Parent Cell Phone(Required)

Please List any Special Dietary Needs and or Allergies:

Please List any Medical Conditions or Accomodations:

Emergency Contact Name(Required)

My student currently attends Glenwood Academy(Required)

Yes

If your student does not currently attend Glenwood, do not submit this form. Please contact Maya Smith at [email protected] - thank you!

Parent/Youth Orientation and Fees

As the parent/guardian of the child above, I understand that all applicable fees associated with Glenwood Academy's Summer Enrichment Program for 2026 are NON-REFUNDABLE and agree that I will attend the MANDATORY parent/youth orientation held prior to the start of the Summer Enrichment Program.

Glenwood Academy Student Fee $150.00 Due at Registration Sign Up
*For multiple children, the first child is $150 and each additional child is $75*
*Registration is INCOMPLETE without FULL payment at the time of Sign-Up*

After you submit this form, we will email you an invoice to pay your fee.

Signature of Parent or Guardian(Required)

First Name Last Name

Date(Required)

Summer Enrichment Registration

Summer
Enrichment Registration