2025 K-5 ESL Summer Program Student Application

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***Please fill out one application per student.

Audience: Current K-5th English Learners

Dates: June 11 - July 3, Monday-Friday
Time: 8:00 a.m. to 3:00 p.m.
Location: Tuggle Elementary (412 12th Ct N, Birmingham, AL 35204)

Students must have completed the BCS Online Registration for the upcoming school year 24-25
Lunch, transportation, and school supplies will be provided.
Wear comfortable clothes and closed shoes for the P.E. class.
Bring a water bottle.

If this student is currently in K-3 grades and has been recommended to attend the Literacy Camp, they must attend their zoned school camp instead.

Learn more about the Alabama Literacy Act English / Español

Email *

Untitled Title

Student First Name *

Student Last Name *

Student ID Number

Gender *

Female

Male

Race and Ethnicity *

White

Asian

Black or African American

American Indian or Alaska Native

Native Hawaiian and Pacific Islander

Hispanic / Latino

Multiracial / Multiethnic

Required

Home Language *

Birth Country *

Does this student participate in the English as a Second Language (ESL) Program? *

Yes

Does this student have an Individualized Education Plan (IEP) - Special Education Services? *

Yes

Student's Grade Level for 2025-2026 school year *

1st

2nd

3rd

4th

5th

6th

School that the student will attend during the 2025-2026 school year *

School that the student attended during the 2024-2025 school year *

Name of Legal Parent/Guardian *

Parent/Legal Guardian's Phone Number *

Parent/Legal Guardian's Email *

Emergency Contact Name *

Relationship *

Emergency Contact Phone Number *

My child will need bus transportation. *

Yes

Home Address *

My child will need afterschool care

***You will need to complete an afterschool care application on site on the first day of Summer Camp.

***Spots fill as first come, first served.

Yes

My child rides together with other siblings/cousins/neighbors attending this same Summer Program. Please write the names of all these students: *

Please tell us if this student has any allergies or dietary restrictions *

Please tell us if this student has any medical conditions or additional important information that we need to know about your student such as medication that the student takes during school hours or any other special care instructions. *

Please check all the boxes:

I understand that...

I must complete the 25-26 BCS Online Registration.

I must complete a separate After School form on site on the first day of Summer Camp if I want my student to receive this service.

My student's bookbag should be mesh or clear.

My student must wear comfortable shoes to exercise in the gym (no sandals).

My student can bring their own lunch if they do not want to eat the lunch provided in our school cafeteria.

My student can bring an empty water bottle to refill in our water stations.

I must pick up my student on time every day if they are car riders or walkers.

I cannot change my student's transportation method unless it is an emergency.

My student must follow ALL the rules stated in the Birmingham City Schools Code of Conduct.

Required

I give my permission to the BCS ESL Summer Camp to photograph and record my child and to share these pictures and video on the school and/or district websites when he/she participates in any academic activities this summer.

Yes

Other:

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