Rooted & Rising: A Winter Girls' Retreat
This 3-day, overnight, lock-in retreat is scheduled for December 27-29 at Girls Inc. in Omaha, Nebraska and is designed to offer teen girls a safe and supportive space with an intentional focus on healing, hope, wellness, identity exploration, and community building through interactive workshops, guided journaling, movement, small group circles, creative expression, and wellness centered self-care activities. This event is free & open to girls in grades 9-12. We are limiting participation to 50 girls to create a holistic and healing centered weekend. Applications will be ranked and girls accepted to the experience will be notified no later than December 5. All questions should be directed to Dr. Marquisha Frost at: tsc@marquishaandco.com
General Information
Youth Name
*
First Name
Last Name
Youth Email
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Youth Phone Number
Please enter a valid phone number.
Youth Birth Date
*
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Year
Grade
*
Youth Pajama Size
Please Select
X-Small
Small
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XXXXX-Large
Rooted & Rising focuses on healing, hope, wellness, identity exploration, and community building through interactive workshops, guided journaling, movement, small group circles, creative expression, and wellness centered self-care activities. In the space below, please share why you're interested in attending and why you should be selected to participate in this year's experience.
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Parent/Guardian Information
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Parent/Guardian Email
*
example@example.com
Emergency Contact Information
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Relationship to Youth
*
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Youth Medical Information
Physician Name
First Name
Last Name
Physician Primary Phone Number
Please enter a valid phone number.
Preferred Emergency Hospital Name
Please list any current medications, medication allergies, food allergies, or chronic health concerns. If none, please indicate n/a
*
If there is any other information that you think would be useful to share, please specify.
PLEASE NOTE THE FOLLOWING:
This is a FREE event. Participation is voluntary. Youth must stay for the entirety of the program. Parents and youth can expect an email confirming acceptance no later than December 5. Pajamas will be ordered for all participating youth.
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