Pre Reg LSPC 2025 | Lori Stephens, LLC

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Powerful Education Solutions Lori Stephens Education Advocate

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(941) 312-4777

Pre-Registration Form for Life Skills Prep Camp 2025

Student's First name*

Sudent's Last name*

Address, City, Zip Code*

Gender

Birthday*

Month

Day

Year

Please list any diagnosis, conditions, allergies, and important information that will help our counselors make this a wonderful experience for your child.

Parent/Guardian Full Name*

Address*

Parent/Guardian Email*

Parent/Guardian Phone Number*

Please choose which Life Skills Prep Camp you are interested in:

June 2-13

July 14-25 (Girls Connection Camp)

Contact

Powerful Education Solutions, LLC

40 Sarasota Center Blvd #101

Sarasota, FL 34240

office@loristephensllc.com

Phone: (941) 312-4777

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