Returning Participant Application
Please fill out this application if you are a returning participant who has attended a C-HOPE program anytime within the past 12 months. Application fees are waived for returning participants.
Which Program Are You Applying To Today?
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Please Select
Afternoon Club - Fall 2026
Participant's Name
*
First Name
Last Name
Email
*
example@example.com
Has there been any changes to the participant's emergency contact information?
*
Yes
No
Please enter the updated emergency contact information.
Emergency Contact #1 Name
*
First Name
Last Name
Emergency Contact #1 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact #2 Name
*
First Name
Last Name
Emergency Contact #2 Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Has there been any medical changes that you'd like C-HOPE's program staff & volunteers to be aware of?
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Yes
No
Please explain the participant's medical changes below.
*
Has there been any behavior changes that you'd like C-HOPE's program staff & volunteers to be aware of?
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Yes
No
Please explain the participant's behavior changes below.
*
Submit
Should be Empty: