Ray's Place Tuesday Night Tutoring/Reading Programs
Event Address: Ray's Place Community Center, 4363 N 6th Street, Harrisburg, PA, 17110
Contact us at 717-545-5200 or email office@LinglestownLife.org for more information or with questions.
Students eligible to participate will be in kindergarten through grade 6

Classes will be held Tuesdays beginning October 11 from 5:00 - 7:00pm.
Parents and Guardians: Watch for information regarding a monthly gathering for adults to support your students.

Our Goal: We want to empower the students from area school districts to remain on-grade level in their reading skills to benefit them during the 2022-23 school year.

Ray's Place Community Center is sponsored by Linglestown Life at Rockville Campus (4368 N 6th Street, Harrisburg, PA, 17110) and is a faith-based institution.
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Email *
Name of Student *
Student Grade Level
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Student Birth Date
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School District My Student Attends
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Student's Mailing Address
Is the student related to anyone else you're registering separately? If so, what is their name?
First Language of Student
We welcome students from any language background as we help students work on English Language skills in this Literacy Camp; we ask this only to best prepare for and accommodate lesson plans, activities, and support for your student(s).
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Parent/Guardian(s) Name and Phone Number
Parent/Guardian Email *
Parent/Guardian Mailing Address
Allergies or dietary needs *
Emergency Contact for Your Student and Phone number: This person has permission to hear medical and other information regarding this student and to make decisions on the behalf of your student.
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Medical or learning needs of student that we should be aware of
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Medical Insurance Policy Number
Medical Insurance ID Number
If your child has an IEP or a behavioral plan at school, are you willing to share some or all information or share strategies to support your child at our facility?
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FOR PARENT / GUARDIAN: BY ENTERING MY NAME OR INITIALS, I UNDERSTAND THAT THIS STUDENT MAY BE PHOTOGRAPHED OR VIDEOTAPED WHILE PARTICIPATING IN SAID ACTIVITIES, AND I GRANT PERMISSION FOR A RECOGNIZABLE IMAGE TO BE POSTED ON APPROPRIATE LLUMC SOCIAL MEDIA PLATFORMS AND OCCASIONAL PRINT MEDIA.
I understand these camps are free to all students through donations from Linglestown Life and other organizations. Are you able or interested in donating snacks or volunteering?
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FOR PARENT / GUARDIAN: BY ENTERING MY NAME OR INITIALS, I GIVE PERMISSION FOR LLUMC AND RAYS PLACE COMMUNITY CENTER, ITS STAFF AND APPROVED VOLUNTEERS TO OBTAIN MEDICAL CARE FOR THIS STUDENT, AND I AUTHORIZE HEALTH CARE PROVIDERS TO RENDER SUCH CARE AS MAY BE NECESSARY. IT IS UNDERSTOOD THAT REASONABLE EFFORTS WILL BE MADE TO CONTACT ME PRIOR TO OBTAINING SUCH CARE, BUT I AUTHORIZE SUCH CARE WHETHER I AM CONTACTED OR NOT, AND I AGREE TO BE FINANCIALLY RESPONSIBLE FOR SUCH CARE. *
FOR PARENT / GUARDIAN: BY ENTERING MY NAME OR INITIALS, IN CONSIDERATION OF THE OPPORTUNITY OF THIS STUDENT TO PARTICIPATE IN THE ACTIVITIES OF LLUMC, I RELEASE LLUMC, ITS STAFF, AND ITS VOLUNTEERS FROM ANY AND ALL LIABILITY OF ANY KIND WHATSOEVER FOR ANY LOSS OR INJURY TO THIS STUDENT ARISING FROM ACTIVITIES ON OR OFF THE PREMISES OF LLUMC OR RESULTING FROM TRAVELING TO OR FROM THE ACTIVITIES OF LLUMC, INCLUDING LOSS OR INJURY RESULTING FROM NEGLIGENCE OR GROSS NEGLIGENCE. I UNDERSTAND AND AGREE THAT THIS PERMISSION AND AGREEMENT SHALL REMAIN IN EFFECT UNTIL REVOKED IN WRITING BY ME, AND I UNDERSTAND AND AGREE THAT IT IS MY RESPONSIBILITY TO UPDATE LISTED MEDICAL AND INSURANCE INFORMATION AS CHANGES OCCUR.
FOR PARENT / GUARDIAN: BY ENTERING MY NAME OR INITIALS, I UNDERSTAND THAT THIS STUDENT MAY BE PHOTOGRAPHED OR VIDEOTAPED WHILE PARTICIPATING IN SAID ACTIVITIES, AND I GRANT PERMISSION FOR A RECOGNIZABLE IMAGE TO BE POSTED ON APPROPRIATE LINGLESTOWN LIFE AT ROCKVILLE CAMPUS/LLUMC OR RAYS PLACE COMMUNITY CENTER SOCIAL MEDIA PLATFORMS AND OCCASIONAL PRINT MEDIA.
FOR PARENT / GUARDIAN: BY ENTERING MY NAME OR INITIALS, I UNDERSTAND THAT THIS STUDENT MAY BE PHOTOGRAPHED OR VIDEOTAPED WHILE PARTICIPATING IN SAID ACTIVITIES, AND I GRANT PERMISSION FOR A RECOGNIZABLE IMAGE TO BE POSTED ON APPROPRIATE LOCAL SCHOOL DISTRICT SOCIAL MEDIA PLATFORMS, NEWS OUTLETS, AND OCCASIONAL PRINT MEDIA.
Would you be open to receiving regular updates about Linglestown Life to be informed with things happening at the church, at Rays Place Community Center, and in our neighborhood?
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A copy of your responses will be emailed to the address you provided.
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