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Auburn University 2014 Summer Reading Program

Mondays and Wednesdays or Tuesdays and Thursdays
June 4 - July 14  or  June 5 - July 15, 2014

 

Child's name: ________________________________________________________________________

Age: ________  Date of birth: ______________________________________    Sex:    Male    Female

Parents or caretakers: __________________________________________________________________

Address: _________________________________________ E-mail: _____________________________

City: ___________________________    State: _____________________  Zip: ___________________

Telephone     Home: __________________  Work: __________________    Cell: __________________

Emergency contact: ____________________________________________________________________

Telephone: _____________________________ Relation: _____________________________________

School and teacher 2013-2014: ___________________________________________________________

Grade 2013-2014: _____ Promoted?  Yes  No   Dual-enrolled in Summer Enrichment Program?  Yes  No

Any special conditions (medical conditions, handicaps, allergies)?    Yes    No   If yes, describe: _______

_____________________________________________________________________________________

Has child been Summer Reading before?  If so, when? _________________________________________

Does child have trouble seeing?    Yes    No    If yes, does child wear glasses/contact lenses?    Yes    No

Does child have trouble hearing?    Yes    No          If yes, does child use a hearing aid?    Yes    No

Does child enjoy reading? _______________________________________________________________

Problems with reading you have noticed: ___________________________________________________

_____________________________________________________________________________________

Topics child might like to read about: ______________________________________________________

Most tutoring will take place in 45-minute sessions between 8:00 and 8:45 twice a week. The tutor will contact you about the specific lesson time. Preferred days for tutoring:

       ____ Mondays & Wednesdays         ____ Tuesdays & Thursdays if available

                  (Grades K-2 only)                             (Grades 3-6 struggling readers)

We will arrange parking in the Stadium Parking Deck for the duration of the program. Parents will deliver children in the Summer Reading Program by foot or shuttle bus to the west entrance to Haley Center on Duncan Drive and meet them there 45 minutes later. Tutoring will take place in 2423 HC.

Driver(s) who will deliver and pick up my child for tutoring: ___________________________________

Car make and license: __________________________________________________________________

Person to contact if child has no ride: __________________________ Phone: _____________________

Please complete both pages of this form.

Please mark class days on the calendar your child could attend tutoring at the Summer Reading Program. (Priority will be given to children who can attend the entire 12-session program and those who have just completed kindergarten or first grade.)

June 2014                                 Monday-Wednesday Program (Grade K-2)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

1

2

3

4 First tutoring (pretests)

5

6

7

8

9 Tutoring

10

11 Tutoring

12

13

14

15

16 Tutoring

17

18 Tutoring

19

20

21

22

23 Tutoring

24

25 Tutoring

26

27

28

29

30 Tutoring

 

 

 

 

 

July 2014

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

 

 

1

2 Tutoring

3

4

5

6

7 Tutoring

8

9 Tutoring

10

11

12

13

14 Last tutoring (posttests)

15

16

17

18

19

 

 

June 2014                   Tuesday-Thursday Program if available (Gr. 2-6 struggling readers)

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

1

2

3

4

 5 First tutoring (pretests)

6

7

8

9

10 Tutoring

11

12 Tutoring

13

14

15

16

17 Tutoring

18

19 Tutoring

20

21

22

23

24 Tutoring

25

26 Tutoring

27

28

29

30

 

 

 

 

 

July 2014

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

 

 

1 Tutoring

2

3 Tutoring

4

5

6

7

8 Tutoring

9

10 Tutoring

11

12

13

14

15 Last tutoring (posttests)

16

17

18

19

 

Hold Harmless Agreement (required)

I, the undersigned parent/legal guardian of _________________________________ acknowledge that accidental injury can result from participation in the Auburn University Summer Reading Program activities. I, therefore, assume all risk, loss, or damage of property arising out of the participation in this program. I release Auburn University, its Board of Trustees, faculty, and staff from all liabilities from any right of action that may accrue either to my child or myself, heirs or representatives, for any such injuries, errors or omissions that I or my child may suffer while participating in this program.

 

________________________________________________     _______________________________

Signature of parent/guardian                                                        Date

If you wish to enroll more than one child, or if you have a friend who is interested in our program, please copy this form and return one form for each child you wish to register. You will be notified about acceptance by early June. If your child is accepted, the fee for the entire program is $80.00, payable at that time, and includes parking in the Stadium Parking Deck during the program. Checks should be made payable to Auburn University. Applications should be sent to:

Dr. Bruce Murray, Summer Reading Program

5040 Haley Center, Auburn University AL 36849

 

For links and lessons about learning to read and pictures from the Summer Reading Program, visit the Reading Genie website: http://www.auburn.edu/rdggenie