Child's Information

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Child's Information

GIRLS ONLY ages 5-12 at time of registration
Event Timing: April 6-10, 2020 7am - 6pm
Cost: $100 in full for all 5 days + $25 Registration Fee (ALL PAYMENTS ARE NON-REFUNDABLE)

Event Address: Girls Inc. 260 Broadway, Richmond, CA. 94804
Contact us at 510-232-5440 (office)
510-809-5744 (Ms. Vicky)
or programs@girlsinc-wcc.org

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E-postadresse *

Child's Name: First, Last: *

Child's Date Of Birth: *

ÅÅÅÅ

Current Grade: *

Current School: *

Race/Ethnicity: *

Home Address: *

City, State, Zip Code: *

Child's Cell Phone & Email: *

Child Lives with: *

Mother

Father

Grandparent(s)

Step Parent(s)

Foster Parent(s)

Andre:

Number of People in Home: *

Primary Language Spoken at Home: *

English

Spanish

Andre:

Neste

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