2014 Leadership Enrichment Adventure Program

Registration Form

Please complete this form and hit "Submit". Office of Transitional Programs will email you more specific information about your preferred LEAP session as early as April 1, 2014. Please note that students do not have a guaranteed placement in their preferred LEAP session until payment is received and confirmed via email ($300 for both the Outdoor and Science Immersion trips, and $250 for the Service Immersion trip). Each session of LEAP can accommodate a maximum of 20 students.

Name
Gender Male    Female
Parent(s) or Guardian(s) Names
Home Address
City
State
Zip Code
Email Address
Phone Number
T-Shirt Size (Adult sizes):
Do you have special dietary needs? (food allergies, vegetarian, etc.)
 
Do you plan to arrive a day early?
Yes
No
Unsure at this time
If yes, Drury's Housing Office will charge $15 to stay on campus.
 
Sign me up for the following LEAP trip:
Outdoor Immersion - Saturday, June 28 - Tuesday, July 1, 2014
Outdoor Immersion - Wednesday, July 9 - Saturday, July 12, 2014
Service Immersion - Saturday, June 28 - Tuesday, July 1, 2014
Science Immersion - Saturday, June 28 - Tuesday, July 1, 2014