Winter Leadership Project Sign-Up Form

Love Progress Park

Winter Leadership Project

Location: Central Piedmont - Cato Campus, 8120 Grier Road, Charlotte, NC 28215

Program Date: 1-day, Saturday, December 10, 2022

Grades: 11th and 12th

Enrollment: November 30, 2022 (Late fee applied after 11/30)

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*
- $35
- $50 (Late Registration fee after November 30)
Today's Total
$0.00