Interested in Attending Our Weekend Programs?
Tell us a little more about your participant by completing the Inquiry Form below, and someone from our Weekend Program Staff will be in touch shortly.

Subject *

Participant Name *

First Name

Last Name

Participant Age

Participant Gender

Parent/Guardian Name *

First Name

Last Name

Parent/Guardian Email *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Program Interests

What programs are you interested in having your child attend? Check all that apply.

Overnight Respite

Adventure Club

HOPeMakers

Teen Programs

Other

Attendance Frequency

How often would you like your child to participate?

Once a week

Once a month

Once a quarter

Once a year

Other

About the Participant

Please tell us about your child, including any social/emotional/medical diagnosis, current support services, strengths and challenges, and keys to success.

Current IEP Status

Does the participant have a current IEP in place?

Supervision Needs

Does the participant require 1:1 supervision at any point in their day?

Yes

How did you hear about HOPe?

Thank you!

For questions, contact Mary O’Toole, Weekend Programs Director.