Youth & Family Interest Form

Interested in WDC’s Youth Development Program? Tell us a little about the student and what they’re interested in. We’ll keep you updated about upcoming Youth & Family Interest Sessions, programs, and opportunities.

Parent/Guardian First Name *

Parent/Guardian Last Name *

Phone *

Email *

Postal Code *

Student Information

WDC's Youth Development Program is designed for middle and high school students.

Student Full Name *

Student School *

Are you completing this form for more than one student? *

Yes

Interests & Opportunities

What types of opportunities are you or your student(s) interested in?
Select all that apply. These are general interests for your family and do not need to apply to every student listed above.Text

I agree to receive text messages and emails from Wezesha Dada Center (WDC) about youth programs, interest sessions, scheduling, and information related to my request. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out of text messages.

I agree to receive marketing and promotional text messages and emails from Wezesha Dada Center (WDC) about programs, events, opportunities, and other WDC updates. Message frequency may vary. Message and data rates may apply. Reply STOP to opt out of text messages.