Girls Inc. Of The Valley - Elementary After-School Program Application (2023-2024 School Year)
**Registration is now full and any new registrants will be placed on a waitlist. We are hopeful that spots will open up within the first month of the program and you will be contacted if a spot opens up for your participant.

To be completed by a parent/guardian. A separate application must be filled out for each child in the household. Space is limited and your spot in the Girls Inc. program will be confirmed via email. Please complete this application to the best of your ability. 

Program Dates: September 11th, 2023 through June 18th, 2024
For students entering grades 3-5 in Fall 2023

Location: Girls Inc. of the Valley, 480 Hampden Street, Holyoke, MA (New Building) 
PROGRAM HOURS: Monday - Friday from 2:30pm - 5:30pm

Sample Schedule:
2:30 pm - 3:30 pm PARTICIPANT ARRIVAL / READING HOUR
3:30 pm - 3:45 pm SNACK
3:45 pm - 4:30 pm GIRLS INC CLUBS I (ex: Outdoor Adventures, Cooking, Art, etc.)
4:45 pm - 5:30 pm GIRLS INC CLUBS II (ex: Dance, Theater, Self-Defense, etc.)
5:00 pm - 5:30 pm PARTICIPANT DISMISSAL

If you have any questions, contact BRANDI KILBOURNE (Director Of Elementary School Programs) at bkilbourne@girlsincvalley.org. 

ESPAÑOL
A rellenar por el padre, la madre o el tutor. Una aplicación separada debe ser llenada para cada niño en el hogar. El espacio es limitado y su lugar en el programa de Girls Inc. será confirmado por correo electrónico. Por favor complete esta solicitud lo mejor que pueda.

Fechas del Programa: 30 de Agosto, 2023 hasta 18 de Junio, 2024
Para estudiantes entrando los grados 3-5 en el otoño 2023

Lugar: Girls Inc. of the Valley, 480 Hampden Street, Holyoke, MA (Nuevo edificio)
HORARIO DEL PROGRAMA: Lunes - Viernes de 2:30pm - 5:30pm

Ejemplo de horario:
2:30 pm - 3:30 pm LLEGADA DE PARTICIPANTES / HORA DE LECTURA
3:30 pm - 3:45 pm MERIENDA
3:45 pm - 4:30 pm GIRLS INC CLUBS I (ex: Aventuras al Aire Libre, Cocinar, Arte, etc)
4:45 pm - 5:30 pm GIRLS INC CLUBS II (ex: Baile, Teatro, Defensa Personal, etc)
5:00 pm - 5:30 pm RECOGIDA DE PARTICPANTES

Si tiene alguna pregunta, póngase en contacto con BRANDI KILBOURNE (Directora de Programas de Primaria) en bkilbourne@girlsincvalley.org.
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GENERAL PARTICIPANT INFORMATION | Información General de Participante 
Participant's first and last name | Nombre del participante *
Participant's gender pronouns | Pronombres del participante *
Required
Participant's Age | Edad del participante  *
Participant's Date of birth | Fecha de nacimiento del participante  *
MM
/
DD
/
YYYY
Participant's Street Address | Direccion  *
City | Ciudad  *
Zip  *
Participant's Cell Phone Number (Phone used by child) | Numero de telefono del participante 
Participant's Email | Correo electronico del participante  *
Participant's School | Escuela  *
School City | Cuidad de la escuela  *
Participant's Expected Grade Level Fall 2023 | Grado en el que estara el participante en Otoñ0 2023 *
Participant's t-shirt size | Tamaño de camiseta  *
Participant Interests (check as many as you'd like): *
Intereses del participante (marque todos que apliquen):
Required
Which days of the week will your child attend Girls Inc? (check as many as you'd like) *
Cuáles días de la semana asistirá su hijo/a a Girls Inc? (marque todos que apliquen)
Required
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