Opening Hearts and Minds to Creative Leadership & Advocacy
Saturdays: February 6th - March 27th
Welcome to the 2021 Winter/Spring Registration Form and Scholarship Application
Safety first! Please supply your information in case we need to contact you or in case of an emergency.

Please fill out a separate form for each child you wish to register. Thank you!
Parent's Name *
Parent's Information:
Please tell us about yourself
Address *
City, State, Zip *
Phone *
Please include area code with periods (ie. xxx.xxx.xxxx)
Email *
Employer *
How did you hear about our program?
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