Secure your spot in the Eryn PiNK Middle School Leadership Program by completing the registration form and submitting the program fee below. Please note: your application is not confirmed until the fee is received.

Spots are limited and fill quickly—registration will close once the program is full.  

If you are in need of financial assistance please email kris@epicyouth.org,

2026 EP Middle School Program

Parent Information

Parent Address
Parent Address
City
State/Province
Zip/Postal

Permission to Participate

REQUIRED PERMISSION: Permission to Participate: I hereby give permission for my child to participate in this program. MY CHILD IS AVAILABLE TO ATTEND EACH DATE. Medical Authorization: I authorize the staff of the summer program to seek medical treatment for my child in case of an emergency, and I agree to be financially responsible for any medical expenses incurred. Transportation Authorization: I give permission for my child to be transported to and from program activities or field trips during the summer program. Photo/Video Release: I consent to the use of photographs or videos of my child taken during the summer program for promotional or educational purposes related to the program. Emergency Contact Information: I confirm that the emergency contact information provided is accurate, and I authorize program staff to contact the listed individual in case of an emergency involving my child.

Payment Information

Payment
$
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