Summer Youth Sign up

Youth Summer Program
Our Mission / Further details
Fathers’ UpLift provides mental health counseling, coaching, and advocacy to assist fathers with overcoming barriers (racism, emotional, traumatic, and addiction-based barriers) that prevent them from remaining engaged in their children’s lives.

This summer, Fathers' UpLift will be offering two groups for youth, beginning July 9th:

one week camp from August 26-30th

Transportation is available on request, though there is a limited number of participants that we can accomidate.
Youth's Name*

First NameLast Name
Is this youth already enrolled in FUL programming?*

YesNoUnsure
Caregiver*

First NameLast Name
Caregiver contact*
Please enter a valid phone number.
Caregiver address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Secondary Contact/Emergency Contact*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.
Which Group are you signing up for?*

Field Games (Ages 10-13)Mind and Body Health (Ages 14-15)
Will your child require transportation?

YesNo
Pick up and Drop off address*
How did you find out about Fathers' UpLift?

Friend or FamilyHealthcare ProviderGoogle or Other search methodsSchool or Educational ProgramOther
Any Allergies?

YesNo
If yes what kind of Allergies?
Should be Empty:

Youth Summer Program