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Menu
  • About
    • Who We Are
    • Careers
  • Services
    • Intervention
    • Enrichment
    • Prevention
  • Events and Programs
    • Retreat
    • 2022 High School Boys Basketball
    • Previous Events
  • Covid-19
    • Managing Stress and Anxiety
    • Speaking with your children about COVID-19
    • Videos
    • Reopening Guidelines
    • Community Resources
  • Parenting
  • Donate
  • Contact

Upward Community’s 3rd Annual High School Girls Retreat- Supported by the Walder Foundation

Participant Legal Name(Required)
MM slash DD slash YYYY
Address(Required)
Participants are allowed to make 2 requests. Upward Community will do our best to place with one of the requests but does not make any guarantees:

Parent or Guardian 1

Name(Required)

Parent or Guardian 2

Name(Required)

Emergency Contact

Name(Required)

Pediatrician Info

Any medication that participant will be taking during the weekend:(Required)
**Please note: Upward Community will not administer medicine or oversee it.
Health and Safety(Required)
HEALTH AND SAFETY: The Parent or Guardian certifies that the child is healthy and able to participate in all Upward Community activities at the time of application. Parent/guardian gives permission to secure proper medical treatment in case of an emergency, when parent/guardian cannot be reached. Parent or Guardian please sign your name:
Waiver for Photo Release(Required)
WAIVER FOR PHOTO RELEASE: I give my consent for any photos/videos taken of my child involved in Upward Community programs to be used for, Upward Community and/or promotions or display. Parent or Guardian please sign your name:
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Payment

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If you would like a payment plan you can do 3 payments of $60.
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