Child's Information
GIRLS ONLY ages 5-12
Event Timing: June 10, 2019 - August 16, 2019 7am - 6pm every M-F
Cost: $100/week/per girl OR $750 in full for all 10 weeks - $35 NON-REFUNDABLE Registration Fee
Event Address: Girls Inc. 260 Broadway, Richmond, CA. 94804
Contact us at (510) 232-5440 or programs@girlsinc-wcc.org
Email address *
Child's Name: First, Last: *
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Child's Date Of Birth: *
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Current Grade: *
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Current School: *
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Race/Ethnicity: *
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Home Address: *
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City, State, Zip Code: *
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Child's Cell Phone & Email:
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Child Lives with: *
Number of People in Home:
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Primary Language Spoken at Home: *
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