Adult's First Name*
 
 
 
 
Adult's Last Name*
 
 
 
 
Email*
 
 
 
 
Phone*
 
 
 
 
Address*
 
 
 
 
City*
 
 
 
 
State*
 
 
 
 
ZIP Code*
 
 
 
 
How many children in your household will be entering first through ninth grade in the fall of 2026?*
 
 
 
 
Which grades will your children be entering in the fall of 2026? Please select all that apply.*
 
 
 
Which Summer Discovery site do you intend to enroll in?*
 
 
 
 
I agree to the terms and conditions. United Way and Summer Discovery partners may contact me.*