2021-2022 L.E.A.D. Group Enrollment Form

Love Progress Park

L.E.A.D. Group Enrollment

Location: Based on your preference or proximity to the nearest Lead Group

Program Dates: Two 12-week sessions: Sep-Dec, Feb-May

Grades: 6th-12th

Enrollment: July 14-August 31, 2021

Enroll Today!

Student's Name*
First Last
Student's Email*
Student's Cell*
Contact Parent's Name*
First Last
Contact Parent's Email*
Contact Parent's Cell*
Student's Date of Birth*
Name of Student's School*
Year of Student's Graduation*
Student's Mailing Address*
Street Address Address Line 2 City State ZIP Code
Student's T-Shirt Size (unisex - adult sizes only)*
Lead Group Coach (type n/a if not sure)*

You will be assigned to a Lead Group closest to your address listed above. If you have a Lead Coach preference, please list this information here.
Lead Group Location (type n/a if not sure)*

You will be assigned to a Lead Group closest to your address listed above. If you have a Lead Group location preference, please list this information here.
Payment Options*
- $570 in-full (SAVE $25)
- $298 in first two months
- $199 in first three months
- $149 in first four months
Every one enrollment provides one backpack filled with school supplies to a student in-need through No BackPack Day.
Today's Total
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