Teen Empowerment Summer Camp

$595

Dates
July 6-10 for Teen Empowerment Summer Camp
SECOND WEEK OF CAMP: (August 3-7)

Please fill out the form below

* Required field

Teen's Full Name*
First Last
Teen's Date of Birth*
School Name*
Teen's Grade*
Any food allergies*
Teen's Cell (if applicable)
Teen's Email (if applicable)
Mom's Full Name*
First Last
Mom's Email*
Mom's Cell*
Dad's Full Name*
First Last
Dad's Email*
Dad's Cell*
Parent's Relationship Status*
Teen lives with the following family members (include age and relationship)*
What made you register for the Teen Empowerment Summer Camp*
What do you hope to get out of this week*
Is there a topic you would like us to specifically cover to benefit your teen
How did you hear about the Teen Empowerment Summer Camp
How did you learn about our program?*
If it was through social media, who's account?
Which session are you registering your child for?*

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Tags: Fall Spring Teens Therapy Tweens

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