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5th Quarter – Medical Form

BEFORE YOU BEGIN — Please review the form first and be sure that you have all of the information you need before filling it out. You will NOT be able to save your work and return to this form at a later time.

When you have the information you need — fill out the Medication Record form below.

When the Medication Record form is completed and you’re ready — click SUBMIT.
IMPORTANT — Stay on this page until the form is done processing — otherwise, it may not go through. You will receive an email confirming LUM has received your form when it is submitted properly.

5th Quarter – Important Information, click HERE.
5th Quarter – main page, click HERE.

For a PDF version of the 5th Quarter Application & Medication Record Forms, click HERE.


5th Quarter – Application

LUM Summer Childcare (5th Quarter) is FULL for Summer 2023

If you wish to be put on the waitlist, please email Kristi at khogue@lumserve.org.


Please read the instructions carefully before beginning. If you have any questions or need assistance, please email Kristi Hogue at khogue@lumserve.org.


BEFORE YOU BEGIN

  • Please review the application first and be sure that you have all of the information you need before filling out the form. You will NOT be able to save your work and return to this form at a later time.
  • When you have the information you need — fill out the registration form below.
  • When the registration form is completed and you’re ready — click SUBMIT.

IMPORTANT — Stay on this page until the form is done processing — otherwise, it may not go through. You will receive an email confirming that LUM has received your registration when it is submitted properly. When typing information into this form, please do NOT use only lower case or upper case letter.

  • 5th Quarter – Important Information, click HERE
  • 5th Quarter – main page, click HERE
  • For a PDF version of the 5th Quarter Application & Medication Record Forms, click HERE.

Lafayette Urban Ministry does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, military status, political association or belief, or union affiliation or activity, in any of its activities or operations.


5th Quarter — Important Information


5th Quarter Summer Learning Program


Dates/times

  • May 27 – August 1, 2025 (subject to change due to snow days)
  • Monday-Friday, 7:30 a.m.-6 p.m.

Location

  • LUM Ray Ewry Youth Center, 525 N 4th St., Lafayette, IN

5th Quarter Application Process — Start HERE


Important Dates

  • Tours Available – by appointment only. Email or call Kristi Hogue to arrange (765.423.2691 | khogue@lumserve.org)
  • Deposit fees due — All deposit fees must be paid in full in order to attend
  • FIRST DAY of 5th Quarter — Tuesday, May 27, 2025 (subject to change due to snow days)
  • Independence Day (observed) — Friday, July 4, 2025 — 5th Quarter is closed
  • LAST DAY of 5th Quarter — Friday, August 1 or 8, 2025

Fees & Payment Policies

  • Every-Two-Week fees are due in advance (Friday before the following week);
    Weekly fees are
    due in advance (Friday before the following week);
    Daily fees are due in advance each day at drop-off
  • LUM accept CCDF Vouchers
  • Openings are first come, first serve. Deposit fees will guarantee a spot for your child(ren) for the weeks indicated. 

3 Ways to Pay — Pay Online -or- Pay in Person -or-  Pay by Mail 

  • Pay Online – through Paypal – click HERE
  • Pay in Person
    • Pay when you drop off or pick up your child(ren)
    • Stop by the LUM Office (420 N 4th Street, Lafayette, IN 47901)
      Monday-Friday: 8:15 a.m. – 4:30 p.m.
  • Pay by Mail – Make checks payable to Lafayette Urban Ministry;
    and mail to Lafayette Urban Ministry, 420 N 4th Street, Lafayette, IN 47901
  • Fees (subject to change):

Sliding Fee Scale – Per Child
Poverty LevelWeeklyDaily
<127%Your family may qualify for CCDF vouchers
128 – 175%$80$25
176 – 400%$90.00$30
400%+$100.00$35

Shot (Immunization) RecordA current shot record with the current year’s date is required before your child(ren) begin(s) the program.


Forms & Information:

  • 5th Quarter – Important Information, click HERE
  • Discipline/Guidance Policy, click HERE
  • Application (PDF), click HERE

Contact information:

Kristi Hogue, 5th Quarter Summer Learning Program director (khogue@LUMserve.org | 765-423-2691)
Text Updates – to sign up for LUM 5th Quarter updates, text @lum5q to 81010


2016-05-24 5thQ 001 Fuse (1280x1133)

What’s Offered

  • Summer childcare with structured learning
  • Dates/times:
    Tuesday, May 27 – Friday, August 1 or 8, 2025 (start date may change due to LSC snow days)
    Monday-Friday, 7:30 a.m.-6 p.m.
    Closed for holidays including Independence Day (Observed Monday, July 4)
  • Location:
    LUM Ray Ewry Youth Center
    525 N 4th St., Lafayette, IN 47901
  • Nutritious snacks
  • Learning based on Indiana Academic Standards in reading, writing, math, social studies and science
  • Recreational and playground activities, Field trips

How to sign-up your children for 5th Quarter:

  • Submit an application — to START the process, click the “Submit an Application” button below
  • Fees (subject to change):
Sliding Fee Scale – Per Child
Poverty LevelWeeklyDaily
<127%Your family may qualify for CCDF vouchers
128 – 175%$80$25
176 – 400%$90.00$30
400%+$100.00$35
  • Due at the registration
  • Application fee will be used for the last week of 5th Quarter
  • Pay Online HERE -or- Pay in Person -or- Pay by Mail 
  • Forms & Information — 5th Quarter:
    • Important Information, click HERE
    • Discipline/Guidance Policy, click HERE
  • Tours Available – by appointment only. Email or call Kristi Hogue to arrange (765.423.2691 | khogue@lumserve.org)

Who’s eligible for 5th Quarter:

  • Limited to 50 children
  • Elementary aged children – starting Kindergarten through completed 6th grade

What you need to submit with your application and registration:

  • Children’s names, date of birth, grade, school name
  • Medical information – medication and allergy information; Immunization Record
  • Educational needs information; Individualized Education Plan (IEP), if applicable
  • Emergency contact information
  • Read and agree to the Discipline/Guidance Policy

5th Quarter Application Process — Start HERE


Lafayette Urban Ministry does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, military status, political association or belief, or union affiliation or activity, in any of its activities or operations.


Other Resources | Home | Top of Page | 5th Quarter Home | ASP Home |


5th Quarter – How to Apply


ENROLLMENT CLOSED – 5th Quarter 2021 is FULL

If you wish to be added to the Waiting List, email Kristi Hogue at khogue@lumserve.org


5th Quarter Summer Learning Program – APPLICATION PROCESS


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5th Quarter application will NOT be accepted until ALL of the below items are submitted.

  1. Fill out the Online Application Form, click HERE
  2. Pay $80 Fee per child; or $25 per day
    • Pay Online HERE -or- Pay in Person -or- Pay by Mail
  3. Submit the following for each child:
    • Online Application Form – Completed, click HERE
    • Immunization Record – current year
    • Individualized Education Plan (IEP), if applicable
    • Payment, if not paid online

Important 5th Quarter Information may be found HERE

  • Includes important information for students & parents
    — dates, open house, fees, forms & more

Who’s eligible for 5th Quarter:

  • Elementary aged children – starting Kindergarten through completed 6th grade
  • Limited to 50 children

Other Resources | Home | Top of Page | 5th Quarter Home | ASP Home |


Contact information:

Kristi Hogue, 5th Quarter Summer Learning Program director (khogue@lumserve.org | 765-423-2691)
Text Updates – to sign up for LUM 5th Quarter updates, text @lum5q to 81010

Behavior Expectations for LUM Camp


Each child is expected to behave in a respectful way at LUM Camp. 


Listed below are rules each child will need to follow to make camp a wonderful experience for all:

  • No put downs or name calling.  Camp is a time to have fun, show respect for each other and make new friends.
  • Each camper is expected to leave his hands and feet to himself and not get into others belongings.  Therefore, we will not tolerate fist fights.
  • Be a good listener and follow directions.
  • Always stay with a counselor or adult leader.  A camper is never to go off by him/herself.
  • Be a team player and display a good attitude.

Parent/guardian of each camper must read and understand the Behavior Expectations of camp.

Parent/guardian of each camper must agree to bring their child home from camp if he/she is asked by the director to leave camp based on the child’s behavior.  

LUM Camp – Important Information

Date — Tuesday, July 29 through Friday, August 1, 2025
Location — Hanging Rock Camp, near West Lebanon in Warren County
Bus Transportation — To & from LUM Camp is provided


Check-In:

  • Date/Time — Tuesday, July 29 at 8:30 a.m.
  • Location — Parking lot at Imagination Station, 600 N 4th St, Lafayette, IN 47901
  • There is no need to arrive early, but please don’t be late!
  • Buses will leave for LUM Camp on Tuesday, July 29 at 9:00 a.m. SHARP

 Pick Up – End of Camp:

  • Date/Time — Friday, August 1 at 2:00 p.m.
  • Location — Parking lot at Imagination Station, 600 N 4th St, Lafayette, IN 47901
  • PLEASE be on time to meet your child
  • No child will be allowed to walk home alone
  • If you cannot pick up your child, please fill out a yellow form to let us know who will be picking up your child

What to Bring (Please label all items with your child’s name)

  • Clothing
    • Jeans, pants, shorts, T-shirts, long sleeve shirt/blouse
    • Underwear, socks
    • Swim suit (must be a one-piece suit for girls)
    • Jacket or sweatshirt
    • Two pairs of shoes (sneakers or tennis shoes)
  • Bedding
    • Sleeping bag or two sheets and a blanket
    • Pillow and pillowcase
  • Hygiene
    • Two towels
    • Soap, body wash
    • Toothbrush and toothpaste
    • Comb, brush
  • Mediations Any medications (prescription or “over the counter”) that your child will need to take. Please bring enough medicine for the entire week.

What NOT to Bring:

  • NO – Cell phones
  • NO – Electronics: including but not limited to Radios, IPods, IPads, laptops, tablets, CD players or video games, etc.
  • NO – Cameras
  • NO – Money (there is nothing to buy at camp)
  • NO – Trading cards, etc.

Cancellation: If your child is unable to attend camp, please let us know as soon as possible so another child may attend.  To cancel, please call 765-423-2691.


Pay Camp Fee: $5 per child

  • 3 Ways to Pay: Pay Online -or- Pay in Person -or-  Pay by Mail 
    • Pay Online – through Paypal – click HERE
    • Pay in Person – stop by the LUM Office (420 N 4th Street, Lafayette, IN 47901), Monday-Friday: 8:15 a.m. – 4:30 p.m.
    • Pay by Mail – Make checks payable to Lafayette Urban Ministry; and mail to Lafayette Urban Ministry, 420 N 4th Street, Lafayette, IN 47901


Contact information:

Marlena Edmondson, LUM Camp director
765.423.2691 | medmondson@lumserve.org


PARENT MEETING

  • Parent/guardian must attend
  • Learn in detail what your child will experience at LUM Camp
  • Date/Time: Thursday, July 24 at 6:00 p.m.
  • Location: LUM Office, 420 N 4th Street, Lafayette, IN
  • ZOOM – To join by Zoom, click HERE

What’s Offered:

  • Week-long, overnight camp
  • Dates: Tuesday, July 29 through Friday, August 1, 2025
  • Location: Hanging Rock Camp, Williamsport, Indiana
  • Swimming, horseback riding, arts & crafts, music, campfire, ice cream social, reading time, and more
  • Meals included
  • Mini-classes and workshops
  • Camp T-shirt

Who’s eligible for LUM Camp:

  • Children between the ages of 8 to 10 years old — during the entire time of camp
    (Tuesday, July 29 through Friday, August 1, 2025)
  • Family must qualify for Federal free lunch, food stamps, or TANF
    — or have a family income at or below 150% of the poverty level
  • Limited to 90 children

What you need to submit with your application and registration:

  • TANF or Food Stamps ID card — or proof of monthly household income
  • Children’s names, date of birth, grade, school
  • Medical information – medication and allergy information, if applicable
  • Emergency contact information (at least two)
  • Read and agree to the Behavior Expectations for Camp
  • Hand-written LETTER to each child. For more detailed instructions, click HERE

Photos

Check out the photos from LUM Camp:
| 2012 | 2013 | 2014 | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | ALL


Dear LUM Camp Parent,

Just a reminder that LUM Camp begins Tuesday, July 29with check-in at 8:30 a.m. in the parking lot TBD. We will return there on Friday, August 1 at 2:00 p.m.

REMEMBER: Send clothing for four days (days are warm, evenings are cool) including a one-piece bathing suit

  • Send two pairs of tennis shoes
  • Each child should bring a sleeping bag (or sheets and blankets) a pillow, towels, and toiletries
  • If your child takes medication, please send enough for the entire week and give all medications to the nurse at check-in
  • Don’t send snacks, money, flashlights or bug spray

There is a Parents Meeting on THURSDAY, July 24 at 6:00 p.m. at the LUM Ray Ewry Center, 525 N 4th Street, downtown Lafayette, IN. Your child’s camp schedule for the week will be shared, emergency numbers to Hanging Rock Camp will be given and LUM Camp staff will be available for questions.

We are looking forward to a great camp week! If you have any questions, please call or email Marlena Edmondson, LUM Camp director (765.423.2691 | medmondson@lumserve.org).

LUM Camp – Registration Form

2025 REGISTRATION is OPEN – Limited Spaces


BEFORE YOU BEGIN — Please review the application first and be sure that you have all of the information you need before filling out the form. You will NOT be able to save your work and return to this form at a later time. Please also read the LUM Camp Behavior Expectations and the HRCA Agreement.

When you have the information you need — fill out the registration form below.

When the registration form is completed and you’re ready — click SUBMIT.
IMPORTANT — Stay on this page until the form is done processing — otherwise, it may not go through. You will receive an email confirming that LUM has received your registration when it is submitted properly. When typing information into this form, please do NOT use only lower case or upper case letter.

LUM Camp – Important Information, click HERE
LUM Camp – main page, click HERE
Behavior Expectations for LUM Camp, click HERE
HRCA Agreement for Waiver and Release, Assumption of Risk & Indemnification, click HERE


Winter Warming Station



What’s Offered: 

  • An indoor place “warm up” and sleep on floor-mattresses
  • Safe, clean & secure

How to Use the Winter Warming Station:

  • Dates: November 15 to April 15 (subject to change)
  • Hours: 9 p.m. to 7 a.m.
  • Location – LUM Ray Ewry Center, 525 N 4th Street, Lafayette, IN
  • CityBus – Route #1A Market Square – Drop off at Brown Street and 4th Street
  • Arrive and check-in — Guests may arrive at anytime after 9 p.m. and are allowed to stay until 7 am.; however, if guests choose to leave early, they will not be allowed to return until the next night

Who may Use the Winter Warming Station:

  • Men & Women
  • Age: at least 18 years old
  • Tippecanoe County residents
  • In good standing with the Winter Warming Station
  • Must not be on the National Sex Offender Registry

LUM strives to ensure the safety and privacy of shelter guests.
To view the Homeless Management Information System (HMIS) Notice of Privacy Practices, click HERE.


Other Resources | Home | Top of Page |


Contact Information:

Mason McConnell Curry, Homeless Services director
mmcconnellcurry@lumserve.org | 765-423-2691

Emergency Shelter

2015-08-24 525 009 (2) (1024x1024)

What’s Offered:

  • Short-term, overnight shelter
  • Open each night of the year from 9 p.m. to 7 a.m.
  • Bunk beds, 6 -8 beds per room
  • Meal after check-in; Breakfast snack & coffee before check-out
  • Showers; free soap, shampoo, etc.
  • Capacity: up to 48 adults each night
  • Safe, clean and caring environment

How to Use the Shelter:

  • Location: LUM Ray Ewry Center, 525 N 4th Street, Lafayette, IN
  • CityBus – Route #1A Market Square – Drop off at Brown Street and 4th Street, Lafayette, IN
  • Must have a PASS to enter
  • Passes are available:
    • Monday – Friday, 8 to 11 a.m. at the LUM Office (420 N 4th Street, Lafayette)
    • Saturday, Sunday and Holidays from 6:00 to 6:30 a.m. at the LUM Emergency Shelter (525 N 4th Street, Lafayette, IN)
  • Check in with a PASS at 9 p.m.; no one will be admitted after 9:30 p.m.
  • Check out at 7 a.m.
  • Winter Warming Station is open from mid-November to April, each night at 9 p.m. No pass needed. For more information, click HERE.

Who may Use the Shelter:

  • Men & Women
  • Age: at least 18 years old
  • Tippecanoe County residents
  • In good standing with LUM

Other Resources | Home | Top of Page |


Contact Information:

Mason McConnell Curry, Homeless Services director
mmcconnellcurry@lumserve.org | 765-423-2691


More Information:


LUM Emergency Shelter Guest – Guidelines

Important information for individuals who are needing to stay as a Guest at the LUM Emergency Shelter is the following:

  • The LUM Emergency Shelter is for temporary stay
  • All Guests must have a pass to enter the shelter each night — Only individuals with passes will be admitted to our temporary overnight shelter
  • Passes are available as follows:
    • Monday – Friday, 8 to 11 a.m. at the LUM Office (420 N 4th Street, Lafayette)
    • Saturday, Sunday and Holidays from 6:00-6:30 a.m. at the LUM Emergency Shelter (525 N 4th Street, Lafayette)
  • Admission procedure is as follows:
    • Every evening of the year – Guests with passes should arrive at the LUM Emergency Shelter (525 N 4th Street, Lafayette) for check-in from 9:00 to 9:30 p.m.
    • Guests may not arrive or gather at the shelter building prior to 9:00 p.m.
    • Guest will not be admitted to the shelter without a pass
    • Guest will not be admitted to the shelter after 9:30 p.m. — under any circumstances
    • For Guests seeking employment — if a guest is seeking employment and intends on continuing his/her temporary stay at the LUM Emergency Shelter:
      • Please seek employment that will enable you to check-in between 9-9:30 p.m. at the LUM Emergency Shelter (525 N 4th St., Lafayette)
      • Must discuss with the Shelter Director ways to get a nightly pass
    • Exceptions to the above requirements may only be made with permission from LUM shelter staff on Wednesday at 8:15 a.m. at the LUM Office (420 N 4th St., Lafayette)
  • Shelter closes the following morning at 7:00 a.m. after guests are provided a light breakfast and coffee, when available.
  • LUM strives to ensure the safety and privacy of shelter guests.
    To view the Homeless Management Information System (HMIS) Notice of Privacy Practices, click HERE.

Other Resources | Home | Top of Page |


 

Homeless Services

LUM offers programs and services for individuals experiencing homelessness who need emergency, temporary, overnight shelter.


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Homeless Services


  • For LUM Assistance Programs, click HERE
  • For LUM Food Programs, click HERE

LUM strives to ensure the safety and privacy of shelter guests.
To view the Homeless Management Information System (HMIS) Notice of Privacy Practices, click HERE.