Register Your Scholar

Scholar Registration for Academic Year 2021-2022, Grades K-5

For Registration questions please contact: Angelina Hunt at 843-331-8526 or info@freedomreaders.org 

Along with the form below, please download and sign our Permission & Release Form. Signed forms may be returned during Session Meetings, or scanned and emailed to: info@freedomreaders.org.

Permission & Release Forms can also be mailed to:
Freedom Readers
PO BOX 30548
Myrtle Beach, SC 29588

Please fill out the following form completely. Required items are marked with an asterisk*.

Session Info

Please check each session your child will be attending *
The Reading Lab (Virtual Tutoring): Open Enrollment
Select Session Location *
The Reading Lab (Virtual sessions scheduled with scholars)

Student Information

First name *
Last name *
Date of Birth *
Age *
Gender
Ethnicity
Grade *
Lexile Level *
Mailing Address *
City, State & Zip Code *
Name of elementary school *
School teacher's name for 2020-2021 school year *

Parent/Guardian Information

Full Name *
Daytime Telephone *
Mobile Telephone *
Email Address *
Would you like to become a volunteer?
Yes, please let me know how I can helpNo, I am not interested at this time.
Would you like to participate in a Community Action Board?
YesNo

In Case of Emergency Contact Information

Full Name *
Relationship to student *
Telephone *

More about your child

Does your child have allergies or any other medical condition? *
YesNo
If yes, please list them:
What would you like us to know about your child?

Verification

Please enter any two digits *Example: 12
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