NWCYC Program Sign-Up
The North Wheeling Community Youth Center is offering a safe, fun, and free educational after school program for all school-aged children of the Ohio Valley.  The goal of our program is to create an environment built on acceptance where children feel encouraged and motivated to better themselves academically, emotionally, and socially. We will also provide snacks, meals, and assistance with homework for the students if needed.  All participants will receive a welcome email with information before the start of the program.  If you have any questions, please feel free to call or text Program Coordinator, Oceanna Smith, at (304) 815-5249 or Asst. Coordinator, Mary Jane Hall, at (304) 312-7259. We look forward to hearing from you!

-Program Dates: January 18th - May 18th
(You will receive a calendar for the dates the Youth Center will be closed for holidays.)

-Days and Times: Monday, Wednesday, and Thursday from 3:00pm-6:00pm
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Email *
Your child's name: *
Preferred Name/Nickname *
Your child's age and grade level: *
What school does your child attend? *
If applicable, please indicate any subject(s) your child may need additional support with. (Ex. Math, Reading, Science)
Which days will your child be attending? *
Required
Parent/Legal guardian name and phone number:
 *
Please list any additional emergency contacts for your child (Include name, phone number, and relationship to the child):
 *
Special circumstances or needs of your child you feel we should know:
Does your child have any allergies, dietary restrictions, or health issues we should be aware of?
Please indicate what your child will be doing at the end of program days:
 *
If applicable, please list ALL individuals who have permission to pick up your child (include name, phone number, and relationship to the child):
Photo Permission:  We want to be able to highlight and document the fun we have at the NWCYC!  Please INITIAL to indicate whether we have permission to take/use photos and videos of your child.
Data Collection:  In order to track program effectiveness and maintain funding, we collect various data involving the demographic and impact of the program.  Please INITIAL if we may use the collected data.
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