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Children’s Summer Reading Program Application Form 2026
"
*
" indicates required fields
Child's Information
Child's Name
*
First
Last
Date of Birth
*
MM slash DD slash YYYY
Gender
*
Male
Female
Other
Grade going into September 2026
*
Grade 2
Grade 3
Grade 4
Elementary School
*
A.S Matheson Elementary
Anne McClymont Elementary
Bankhead Elementary
Black Mountain Elementary
Chief Tomat Elementary
Chute Lake Elementary
Davidson Road Elementary
Ecole Belgo Elementary
Ecole Bellevue Creek Elementary
Ecole Casorso Elementary
Ecole Dorothea Walker Elementary
Ecole Glenmore Elementary
Ecole Glenrosa Elementary
Ecole Hudson Road Elementary
Ecole Peter Greer Elementary
Ellison Elementary
Helen Gorman Elementary
Mar Jok Elementary
North Glenmore Elementary
Oyama Traditional School
Peachland Elementary
Pearson Road Elementary
Quigley Elementary
Raymer Elementary
Rose Valley Elementary
Rutland Elementary
Shannon Lake Elementary
South Kelowna Elementary
South Rutland Elementary
Springvalley Elementary
Watson Road Elementary
Webber Road Elementary
Other
Your child's most recent PM Benchmark Reading Level, as provided by their school. (If you are unsure, select the closest one – we will be asking for the correct one at a later time)
*
1-5
6-10
11-15
16-20
21-25
26-30
Which session is your TOP CHOICE to attend?
*
Session 1 (July 6-16)
Session 2 (July 20-30)
Session 3 (August 10-20)
Which session is your SECOND CHOICE to attend? (if you only have 1 session availability, please leave this blank)
Session 1 (July 6-16)
Session 2 (July 20-30)
Session 3 (August 10-20)
N/A
Which session is your THIRD CHOICE to attend? (if you only have 1 session availability, please leave this blank)
Session 1 (July 6-16)
Session 2 (July 20-30)
Session 3 (August 10-20)
N/A
Parent/Guardian Information
Parent/Guardian #1 Name
*
First
Last
Parent/Guardian #1 Address
*
Street Address
Address Line 2
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Parent/Guardian #1 Phone Number
*
Parent/Guardian #1 Email Address
*
Parent/Guardian #2 Name
First
Last
Parent/Guardian #2 Address
Street Address
Address Line 2
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Parent/Guardian #2 Phone Number
Parent/Guardian #2 Email Address
Medical Information
Please list any of your child's allergies or medical conditions, if any.
If required, does your child have an EpiPen?
Yes
No
Daytime Emergency Contact Name
*
First
Last
Daytime Emergency Contact Phone Number
*
Is there anything else you would like us to know about your child?
Important Consent Forms
Attendance
*
Please read and check.
– Students must be available to attend all eight lessons in the program to be eligible to register.
– To help ensure the health and safety of everyone participating in the program, it is advised that students stay home if they are feeling sick. If they fall ill during the program, the parent/guardian will be contacted to pick up the student.
– We encourage families to drop off students no later than 9:30am and pick them up promptly by 12:30pm.
Child Supplies
*
Please read and check.
Please make sure your child brings the following to EACH class:
– Snacks
– Water bottle
– A change of clothing
– Sunscreen and hat
– a backpack (to carry and store books/materials)
Code of Conduct
*
Please read and check.
– Out of respect for all the participants in the program, the use of cellphones/electronics is not allowed during class.
– The safety and well-being of each individual is very important to Project Literacy. I hereby agree that any behaviour of the student that places himself/herself or others at risk may result in the student’s immediate dismissal from the program.
Name
This field is for validation purposes and should be left unchanged.