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Health and Wellness Staycation
Charis Humphrey - Youth Coordinator ECRJC -
chumphrey@ecrjc.org
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Email
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Your email
First Name
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Your answer
Last Name
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Your answer
Age
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Your answer
Zip code
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Your answer
Email
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Your answer
Phone
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Your answer
Best way to contact you
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Email
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All of them
For the Creativity part of my day I'm interested in
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Painting and Collage
Dance and Movement
Poetry and Stories
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For Movement part of my day I'm interested in...
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Somatics - movement study that emphasizes internal physical perception and experience
Yoga - breath control, simple meditation, and the adoption of specific bodily postures
Parent/Guardian Name:
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Parent/guardian phone:
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Your answer
Do you need transportation?
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Your answer
Do you have food restrictions?
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Your answer
I understand that I am required to pay $10 to complete my registration
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Yes
I need to talk about it
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