Writers Registration

^{Enhancing life from Language 2 Literacy}

Writers in the Works Registration

Please fill out this form completely and hit "submit."
Please read Terms and Conditions below.

To complete your registration, please go to Online Store,
where you may use PayPal or a credit card.

Don't forget to enter WriterWork in the Coupon
for $50 off - $245 TOTAL!

Child's Full Name: *

Age: *

Grade in fall 2009: *

School in fall:

Address Street 1:

Address Street 2:

City:

Zip Code:

(5 digits)

State:

Daytime Phone: *

Cell Phone:

Email:

How did you hear about our program?:

Parent/Guardian responsible for child:

Please select program
and class times

Elementary 4th, 5th, 6th

Monday/Wednesday $295

Please select a time

9:00 am to 11:30 am

Jr. High 6th, 7th, 8th

Tuesday/Thursday $295

9:00 am to 11:30 am

Terms and conditions

1. PARTICIPANTS MUST BE IN GOOD HEALTH. All participants must be free from fever and any contagious illness for 24 hours before returning to our program.
2. ALL SUMMER BOOST FEES MUST BE PAID IN FULL AT TIME OF REGISTRATION.
3. THERE WILL BE NO REFUND OF SUMMER BOOST FEES FOR ANY REASON.
ENROLLMENT IS LIMITED. Language 2 Literacy contracts for counselor services and program needs are based on confirmed enrollments. Summer programs rely on fees for the continuous and uninterrupted operation of the program. Fees must be paid in full without deduction or allowance for absence or withdraw.
4. NO MAKE-UPS will be allowed for missed sessions.
5. LANGUAGE 2 LITERACY IS NOT RESPONSIBLE FOR LOST OR STOLEN ITEMS.
6. CHILD’S PHOTOGRAPH may be used in Summer Boost brochure, website and other
promotional materials.
7. RETURNED CHECKS: There is a $45.00 charge for returned checks.

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