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ELI 

Acceptance
Form

Congratulations! If you received a letter of acceptance for the ELI  Program you are in the right place. Next you will have to fill out the form below. When filling out the form, make sure you have any paperwork that was included in your acceptance packet and a copy of the front and back of your insurance card.
 

There are 7 sections on this form.
Be prepared for the following:

1 | Contact Information
Provide your name, phone number, email, and other essential details so we can stay in touch.

2 | Parent Information
Include emergency contact details and parent/guardian information for safety and communication purposes.

3| Note to Parent/Guardian
A brief but important message for parents and guardians — please take a moment to read before continuing.

4 | Community Service Requirement
Details about the required community service project, including expectations and deadlines.

5 | Code and Conduct
Review the behavior guidelines and expectations all students must agree to before participating.

6 | Media Release
Information about photo/video permissions related to program events and activities.

7 | Health Insurance & Release Form Upload a clear image of the front and back of your health insurance card. This is required for participation.

Need Help?

If you have any questions, please contact:

Amber Decker

606-677-6000

Please read this form carefully before submitting as it includes information regarding medical care and rules and regulations for camp if you are called to attend.


Please submit the form by the deadline. If you do not fill out the form by the deadline, you will forfeit your position as an alternate.

Shirt Size
Please select the choice that applies:
Yes, I accept my selection for the ELI Program.
Yes, I accept my selection as an Alternate in the ELI Program.
No, I will not be able to participate in the ELI program.
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