2026 Green Grid Leadership Academy Registration

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* 1. Which Summer camp sessions are you registering your camper for?

Full Summer Camp (June 8- July 31, 2026)

First Half Only (June 8- July 3, 2026)

Second Half Only (July 6- July 31, 2026)

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* 2. First & Last Name

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* 3. Date of Birth

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* 4. Age (as of June 1st)

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* 5. School Name

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* 6. Last Grade Completed

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* 7. Home Zip Code

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* 8. Race/Ethnicity

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White

Other

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* 9. Gender

Male

Female

Non-binary

Prefer not to say

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* 10. T-Shirt Size

AXL

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* 11. Primary Contact Name

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* 12. Relationship to Camper

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* 13. Phone Number

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* 14. Email Address

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* 15. Home Address

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* 16. Zip Code

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* 17. Food Allergies/Dietary Restrictions

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* 18. Emergency Contact (Secondary)

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* 19. Emergency Phone

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* 20. Field Trip Fee Acknowledgment-$100

I understand this fee secures my child’s spot and covers transportation/entry fees for summer field trips.

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* 21. Attendance Policy Acknowledgment

I understand that consistent attendance is vital for my child to complete the solar-power and gardening projects.

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* 22. Photo Release Permission

I give permission for my child to be included in photos/videos for Legacies United Foundation and City of Columbus project reports.

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* 23. Capacity Notice Acknowledgment

I understand that registration is limited to 75 students. If the program is full, I will be added to the waiting list.

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* 24. After the regular summer camp ends, we offer optional Saturday Specialty Camp Days. Please let us know your interest and which dates you may attend?

	8.8.26	8.15.26	8.22.26	8.29.26	9.5.26	9.12.26	9.19.26	9.26.26
Yes, we plan to attend Saturday Specialty Camp	Yes, we plan to attend Saturday Specialty Camp 8.8.26	Yes, we plan to attend Saturday Specialty Camp 8.15.26	Yes, we plan to attend Saturday Specialty Camp 8.22.26	Yes, we plan to attend Saturday Specialty Camp 8.29.26	Yes, we plan to attend Saturday Specialty Camp 9.5.26	Yes, we plan to attend Saturday Specialty Camp 9.12.26	Yes, we plan to attend Saturday Specialty Camp 9.19.26	Yes, we plan to attend Saturday Specialty Camp 9.26.26
Maybe, we are interested but unsure at this time	Maybe, we are interested but unsure at this time 8.8.26	Maybe, we are interested but unsure at this time 8.15.26	Maybe, we are interested but unsure at this time 8.22.26	Maybe, we are interested but unsure at this time 8.29.26	Maybe, we are interested but unsure at this time 9.5.26	Maybe, we are interested but unsure at this time 9.12.26	Maybe, we are interested but unsure at this time 9.19.26	Maybe, we are interested but unsure at this time 9.26.26
No, we are not interested in Saturday Specialty Camp Days	No, we are not interested in Saturday Specialty Camp Days 8.8.26	No, we are not interested in Saturday Specialty Camp Days 8.15.26	No, we are not interested in Saturday Specialty Camp Days 8.22.26	No, we are not interested in Saturday Specialty Camp Days 8.29.26	No, we are not interested in Saturday Specialty Camp Days 9.5.26	No, we are not interested in Saturday Specialty Camp Days 9.12.26	No, we are not interested in Saturday Specialty Camp Days 9.19.26	No, we are not interested in Saturday Specialty Camp Days 9.26.26

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* 25. Therapeutic Behavioral Health (Optional)
Our specialists offer integrated support for social-emotional learning and behavioral needs through 1-on-1 coaching, peer "Dialogue Sessions," and family advocacy. Would you like to learn more or have your child screened for eligibility for these supportive services?

YES, I am interested in individual/group behavioral health support for my child.

NO, I am not interested at this time.

Thank You Someone from our Team will be in Touch with you Soon!!!! Visit Us at LegaciesUnite.org for more info!!!