LPP's "To Infinity & Beyond" Summer Program
This summer we have an exciting 4-week, Monday through Thursday program planned.  We are offering a mix of hands-on science experiments, arts, crafts, and fitness activities themed around motivating our youth to be creative, innovative, and to think about their future beyond today! 
We are also excited to welcome students in grades 5th -7th from all of the schools across Newburgh Enlarged City School District (applicable schools are noted on application). Our program will run from July 8th to August 2nd and is free to all participants.  Once your application is received there will be more information to follow! Should you have any additional questions, please feel free to contact our office at 845-341-9451 or you can email any questions to liberty@sunyorange.edu. Please note if you have more than one child you are registering, please complete this form for each child. 
Sign in to Google to save your progress. Learn more
Email *
Student Full Name *
Students School ID # *
Student D.O.B *
Did/Does your child attend the SUNY Orange LPP afterschool program? (2023-2024) *
Student's Current School  *
Student's Current Grade *
Student's T-Shirt Size *
Parent Full Name *
Current Full Address *
Parent Phone Number *
Parent Cell Phone Number *
Parent Email Address *
Emergency Contact #1 Name *
Emergency Contact #1 Phone Number  *
Emergency Contact #2 Name *
Emergency Contact # 2 Phone Number  *
We will need a copy of your student's most recent report card or five-week progress report. You may drop it off to our office or email it to liberty@sunyorange.edu. Please select that you acknowledge this request.  *
Please note that SUNY Orange LPP does not provide transportation to or from the program during summer hours. You will need to provide this for your child. Please select that you acknowledge this. *
SUNY Orange LPP has a strict cell phone policy. Participants will not be allowed to use their cell phone during program hours. Cell phones will be collected in the morning and returned prior to dismissal. Should you need to get ahold of your child, please contact the main number. This policy is non-negotiable. Please discuss this policy with your child and select I acknowledge this.  *
SUNY Orange LPP does not condone any type of violence against each other or staff, nor the recording or disseminating of such acts  in video and/social media. Should such an act occur, those responsible will be terminated from the program. Please discuss this policy with your child and select that you acknowledge.  *
Does your child have any food allergies that we should be aware of? *
Does your child have any allergies that the staff/program should be aware of? *
Does your child know how to swim? *
There will be a MANDATORY summer program orientation for students and parents. Please ensure that you respond to any emails or REMIND text when this information is sent. *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of SUNY Orange. Report Abuse
Google Forms