EmpowerHER Summer 2025 Registration

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This program is now full. If you would like to add your child to the wait list, please fill out and submit this form. If a spot opens up, we will contact you. Thank you.

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This 6-week research-based program is designed to help girls develop self-esteem, gain self-awareness, form friendships with peers and feel more empowered!

PLEASE NOTE: Since space is limited, we expect that registered children will be attending the majority of the program sessions. If your summer plans change and your child is unable to attend the program regularly, please let us know as soon as possible so that we can offer the spot to another child.

Child's Name (one child per form please)*

First NameLast Name

Grade as of September 2025*

5th6th7th

Parent's Name*

First NameLast Name

Parent's Email*

example@example.com

Parent's Cell Phone*

Please enter a valid phone number.

Emergency Contact Information*

Name

Relationship to child

Best number to call in an emergency

Please list the name, phone number and relationship, of those allowed to pick up your child.

My Products

EmpowerHERWednesday’s, July 16th - August 20th, 6:00pm - 7:00pm

$ Free

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.