Clone of Summer Camp Detailed Registration Form

Student's Name

First NameLast Name

Raleigh County Schools is excited to offer a free summer school program for our elementary students! The program will run from Monday, July 6 through Friday, July 24, 2026. Students will attend Monday through Friday from 9:00 AM to 2:00 PM each day. Transportation will be available at designated stops for your convience.

The focus of the program will be on strengthening skills in English Language Arts (ELA) and Math to help students stay on track and prepare for the upcoming school year. Free breakfast and lunch will be provided for all students. This is a wonderful opportunity for students to keep learning, stay engaged, and have fun over the summer. We look forward to seeing your child there!

Birth Date

MonthDayYear

Gender

2025-2026 Grade Level:

This is the grade your child is this current school year.

What school does your child attend?

Does your child have an IEP?

Physical Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information

Name

First NameLast Name

Cell Number

Format: (000) 000-0000.

Alt. Number

Format: (000) 000-0000.

E-mail

example@example.com

School Choice: Which summer school location would you like your child to attend?

Does your child need transportation?

Does your child have any of the following medical conditions: check all that apply

Is there any additional information you would like to share regarding the student’s medical condition that may help us better support their needs?

I give permission for my child to be photographed for news events, and social media sites.

Raleigh County Summer School Registration

Student Information

Summer School Information

Medical Information