Clone of Summer Camp Rise 2026

Get Ready for High School with the NAYA Ninth Grade Counts Summer Program!

Are you heading into 9th or 8th grade and looking for a fun, hands-on way to prepare for high school? The NAYA Ninth Grade Counts Summer Program is a free, two-week camp designed just for you.

Eligibility:

- Students who will be 9th graders in the academic year of 2026-2027 and attending a high school in Multnomah County.

- Students who will be 8th graders in the academic year of 2026-2027 and attending a middle school in Multnomah County.

(NOTE: upcoming 8th graders will NOT be able to earn the .5 high school credit, but will be able to attend Ninth Grade Counts the following year.)

What to expect:

Each day starts with interactive sessions to help you build skills and confidence for high school, like understanding graduation requirements, learning new study strategies, and setting yourself up for success with career exploration. Then, you’ll dive into workshops that will include movement, indigenous arts, and more! Throughout the two weeks, students will have the opportunity to visit a college campus and do something fun to finish it off! It's the perfect opportunity to make new friends and connect with peers learning alongside you! Free lunch and snacks will be provided!

PLUS! A $100 gift card upon successful completion of Ninth Grade Counts!

Time and place:
- Drop-off @ 10am and Pick-up @ 5pm
- Location: NAYA - 5135 NE Columbia Blvd, Portland, OR 97218
- Week 1: July 13th - July 16th, Monday - Thursday
- Week 2: July 20th - July 23rd, Monday - Thursday
NAYA Staff Info:
- Fabian Villarreal (she, her) College Prep Coach
- Email: villarrealf@nayapdx.org
- Call/Text: (971)358-8531
- Please call, text, or email with any concerns, questions, or comments.
  If the online format of this application causes barriers, we are happy to make accomodation as capacity allows.
Student Info
Student Name

First Name (Preferred Name)Last Name
Student Birthday

MonthDayYear
Date
Pronouns
Example: she/her, he/they, they/them
To be eligible, will the student be in the 8th or 9th grade for the academic year of 2026-2027 in the Multnomah County?
Do you understand that 8th graders for the academic year of 2026-2027 are not eligible to earn the .5 high school credit?
Do you understand that students must attend 7 out of the 8 days of Ninth Grade Counts and complete 80% of the work in order to earn the $100 gift card and/or .5 high school credit?
Student Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Student Gmail
Please provide an actual student Gmail as this will be required for class projects. You are encouraged to make a Gmail for the student if access allows. Please let us if there are any barriers to this.
School District
School Name
If you selected "Other" please list the school district
Student Synergy Number
if unknown, please enter 00000
Student's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Info
Parent/Guardian Name

First NameLast Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact 1 Name

First NameLast Name
Relation to student?
Emergency Contact 1 Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please list any Medical Conditions/Allergies that the student may have:
If none, please enter n/a
Please List any Dietary Needs/Restrictions that the student may have:
If none, please enter n/a
Please list any special accommodations the student may have/require
If none, please enter n/a
Please list any medications student may have/require:
If none, please enter n/a
Insurance provider and policy number, as well as the personal physician or clinic of the student:
Acknowledgements

As the Parent/Guardian of the student applicant, by providing my e-signature, I give my permission for the student to participate in the NAYA Ninth Grade Counts 2026 field trips. By signing this agreement, I acknowledge that NAYA has my permission to drive my child in NAYA-owned vehicles, staff vehicles, and chartered buses, and include my child in all of the NAYA Spring Break Camp 2026 activities. In the case of an emergency, the signature provided does hereby consent to any and all medical and surgical treatment, including anesthesia and operations which may be deemed advisable by the physician and surgeons, to perform all examinations. I also agree that the patient, when admitted, is to remain in the hospital until their physician recommends the patient's discharge. NAYA will not be held liable for any injuries or accidents caused to the student if they choose not to follow NAYA staff directions or rules.
Parent/Guardian Signature

If applicant is 18 or older, they may sign for themselves.
NAYA Legal Consents and Releases

Please review with your student as the parent/guardian.
Have you received or participated in NAYA services before?
Non-Discrimination Agreement

We, the organizers, parents, guardians, participants, students, teachers, and staff of NAYA Youth and Family Center, hereby pledge to create an environment that is inclusive, respectful, and free from discrimination of any kind. We believe in the inherent dignity and worth of every individual and are committed to upholding the following principles:
- Equal Opportunity: We affirm that all individuals, regardless of race, color, ethnicity, nationality, religion, gender, gender identity, sexual orientation, disability, socio-economic status, or any other characteristic, have the right to equal opportunities and treatment within our program.
- Respect and Dignity: We will treat each other with respect, dignity, and empathy. We recognize that everyone brings unique perspectives, experiences, and talents to our community, and we value this diversity.
- Non-Discrimination: We will not tolerate any form of discrimination, harassment, or prejudice. This includes but is not limited to actions or language that is racist, sexist, homophobic, transphobic, ableist, or otherwise discriminatory.
- Zero-Tolerance for Isms and Phobias: We have a zero-tolerance policy towards all forms of isms (such as racism, sexism, ableism, etc.) and phobias (such as homophobia, transphobia, etc.). Any behavior or language promoting such ideologies will not be tolerated and will result in immediate disciplinary action.
- Decolonization: We acknowledge the historical and ongoing impacts of colonization on marginalized communities. We commit to challenging colonial structures, narratives, and practices within our program. This includes centering Indigenous knowledge, perspectives, and voices, as well as amplifying the experiences of marginalized groups.
- Inclusivity: We are committed to creating an inclusive environment where all individuals feel welcome, valued, and supported. We will strive to foster an atmosphere of openness, acceptance, and understanding.
- Accessibility: We will make reasonable accommodations to ensure that our program is accessible to individuals with disabilities. We will also consider the diverse needs of participants and work to address any barriers to participation.
- Conflict Resolution: In the event of conflicts or concerns related to discrimination or harassment, we will address them promptly and fairly. We encourage open communication and constructive dialogue to resolve issues and promote mutual understanding.
By agreeing below, we affirm our commitment to these principles and pledge to uphold them throughout the duration of participating in the NAYA Spring Break Camp 2026 and NAYA Youth and Family Center.
I agree:
Cell Phone and Technology Usage:

I understand that excessive use of such devices can disrupt the learning environment and negatively impact the experience for myself and others. I agree to check in cell phones or any other devices with NAYA staff. Cell phones will be locked into device pouches. Students can be reached through the assigned point of contact for NAYA Ninth Grade Counts 2026 during programming.
I agree:
Permission/consent to photograph, video, interviews and quotations:

I give consent for myself or my child to participate in NAYA Family Center marketing activities, including interviews, the use of quotes, and the taking of photographs, movies or video tapes by NAYA Family Center employees. I grant NAYA Family Center the right to edit, use, and reuse said products for non-profit marketing purposes including use in NAYA Family Center grant writing and marketing in print, on the internet, and all other forms of media. I also hereby release NAYA Family Center and its agents and employees from all claims, demands, and liabilities whatsoever in connection with the above.
I agree:
Consent to Emergency Care and Relevant Information:

In the event of an emergency, if reasonable attempts to contact persons listed are unsuccessful, I give consent to the NAYA Family Center to transport myself or my child to the doctor or to the Emergency Medical Department of the nearest hospital. If my doctor cannot be contacted, all medical treatments deemed necessary by the attending licensed physician, including examinations, anesthesia, operations, and diagnostic procedures, may be administered. I further acknowledge that I will be responsible for all fees and costs associated with the medical treatment that are not covered by my insurance.
I agree:
Consent for Transportation in NAYA Vehicles and NAYA Staff Vehicles:

I understand that NAYA Family Center programs and activities may include local and long distance travel, and give permission to the NAYA Family Center to provide transportation. The participant understands and agrees to abide by the following rules with being transported.
- All participants must be responsible for wearing seatbelts at all times.
- All children under 80 lbs. are required to be properly placed in a child seat or booster seat.
- Appropriate conduct will be mandatory when being transported.
- Smoking is not allowed in NAYA Family Center vehicles or personal staff vehicles when being transported.
A participant may be subject to suspension of transportation privileges if found in violation of any rules of transportation, or for disobeying the NAYA Family Center staff providing the transportation.
I agree:
NAYA Internal Information Sharing Agreement:

Information sharing within NAYA services, or internal information sharing between staff, is often necessary in order to better serve the participant and family. Please indicate your agreement for NAYA staff to share your information within NAYA programs as needed to provide services. By acknowledging Yes, you understand that electronic mail (e-mail) is not confidential and can be intercepted and read by other people.
I agree:
Parent/ Guardian Name

First NameLast Name
Parent/Guardian Signature
Date of Signature

MonthDayYear
Date
Student Name

First NameLast Name
Student Signature
Date of Signature

MonthDayYear
Date
You will be sent a copy of this form upon submission.

Please keep an eye out for any emails, calls, or text messages from us for notices and updates!

Please contact us with any questions, comments, or concerns.

Fabian Villarreal (she, her)

College Prep Coach

Email: villarrealf@nayapdx.org

Call/Text: (971)358-8531
Should be Empty:

Student Info

Parent/Guardian Info

Acknowledgements

NAYA Legal Consents and Releases