THRIVE!-4-Kids Small Group Mentoring Registration
Date & Time
August 1, 2025 3:30 PM - December 15, 2025 5:00 PM
86 out of 127 remaining tickets available
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Youth Age 8-12 yrs old
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Youth Age 8-12 yrs old
0
First Name
*
Last Name
*
Please choose the best location and day
*
Cypress Pines- Mondays & Tuesdays at 4pm
Monterey Pines- Mondays &Tuesdays at 5pm
Online Via Zoom- Wednesdays at 6:30pm
Emerging Leaders Academy (ages 13-16) Wednesdays at 6:30pm via Zoom
Parent/Caregiver's Mobile Number
*
Parent/Caregiver's Email Address
*
Gender
*
Male
Female
Date of Birth
*
Ethnicity
*
American Indian - Alaska Native
Asian
Black or African American
Hispanic or Lantino
Middle Eastern or North African
Native Hawaiian or Pacific Islander
White or Caucasian
School Grade
*
-- None --
Nursery/Pre-school
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Name of School
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Does your child have an IEP (Individual Education Plan) or 504 Plan to support their academic needs?
*
YES
NO
Who Referred You?