Power Up for Summer Participation Form

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Thank you for your interest in joining us for "Power Up" day at Young Men's and Women's Leadership Academy at Butler!

We have a jam-packed morning filled with activities for any age, from readings with the Jacksonville Public Library to Zumba with Kay to Painting with Renewed Community Initiatives.

Check-in begins at 8am and the day kicks off at 8:30am. Indicate which activities you'd be most interested in by completing the form below. Once you have completed the form, we will confirm your RSVP.

First Name *

Last Name *

Preferred Email *

Cell Phone *

Please select 2 activities you'd like to participate *

Zumba

Mural Painting

Garden box project

Library Reading

Poetry

Required

List first name & age of students/children you will be bringing

Submit

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