Read to Lead After-School Program Registration
Please complete this form to register your student for the Read to Lead after-school program. Program hours are 4:30-7:30 on Monday, Tuesday, and Thursday. We have limited transportation available based on need. We look forward to working with your student!

Greater Israel Baptist Church
1509 Magazine Street
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Student Name
Student Birthday
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/
MM
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Student Grade
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What school does your child currently attend?
Does your child have an active 504 or IEP?
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Is there anything you would like us to know about your child?
Who will be providing transportation?
Parent/Guardian Name
Parent/Guardian Phone Number
Parent/Guardian Email
Emergency Contact Name
Emergency Contact Phone Number
I Would Rather Be Reading is a local non-profit organization whose mission is to provide equitable access to literacy instruction, enrichment opportunities, and advocacy. In order to provide affordable programming to families and students, we depend on the generosity of local donors, organizations, and individuals. We are very active on social media,  frequently  posting pictures and videos  to keep donors engaged and to secure continued financial support for programming. Please type your name below to acknowledge your consent for IWRBR to use pictures and videos of your child/ren on any and all social media, website, and marketing materials.
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