Moorelands City Youth (VITAL) Application

Please complete the below application to apply for Moorelands City Youth (VITAL) program. If you would like to learn more about the program, click here.

Please enable JavaScript in your browser to complete this form.
Step 1 of 5

Participant Information

Participant Name
As of September 2024
As part of our efforts to support the participants in our High School programs, we may contact them directly through email or text message. This will help them be more successful in the program. At any time, you may request a log of communication and Moorelands Kids will provide it to you. Do you give us permission to contact your child through email and/or phone?
Has the participant attended a Moorelands Kids program before?
Which Moorelands City Youth (VITAL) session do you prefer?
If your preferred time is full, can your child attend the other time?

SUBSCRIBE TO OUR NEWSLETTER

STAY UP TO DATE WITH WHAT’S GOING ON AT MOORELANDS!

Please enable JavaScript in your browser to complete this form.
Name
Do any of the following apply to you?