Wide Horizons, Inc. - 2023 Summer Enrichment Program Application

2023 Summer Enrichment Program Application

Thank you for your interest in the 2023 Summer Enrichment Program (June 12 - July 28, 2023.) Please fill out the application below to start the enrollment process. If you have any questions, feel free to call us at 209-629-8968.

Parent / Guardian First Name

Parent / Guardian Last Name

Parent / Guardian Email

Parent / Guardian Mobile Phone

The cost of the 2023 program is a $500. A limited numbers of scholarships are available.

Our admissions team will work with you determine if our Summer Session may be a good fit for this potential Participant and scholarship eligibility.

It is the policy of Wide Horizons, Inc. to admit and treat all individuals without regard to race, religion, color, sex, national origin, or sexual orientation.
Note: Criteria that may make a participant ineligible for the program include but are not limited to: current or recent significant behavioral or psychological issues, a significant history of violence to self or others, and/or current substance abuse issues. Additionally, Wide Horizons and its programs provide a smoke-free / vape-free environment. The use of any tobacco or vape products are not allowed and is strictly enforced.

I Agree to the Terms

Form of Payment

Participant Information

Participant First Name

Participant Last Name

Participant Birth Date

Relationship to Parent / Guardian

Emergency Contact #1 Cell Phone Number

Method of Travel to the Summer Sessions

Current living arrangement

Diagnosis of Special Needs

Allergies

Favorite Things to Do

Remove

Additional Participant Information