Reading and Succeeding Reading

Please register for each child individually in the form.

Fields marked with an * are required.

Student Information
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Has your child attended the Loyola Clinical Centers for service(s) in the past?

Parent/Guardian Information
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Preferred Method of Communication:



Emergency Contact Other Than Parent(s)

Parents/guardians will be contacted first.

Allergy
Consent to Release
Columbia Schedule
8 years old+ small group sessions/ 1.5 hrs T-Th
Baltimore Schedule
How did you hear about our Summer Reading Programs?