One moment please...
Y-WE 2023 Black and BIPOC Girls/Non-Binary Summer Programs
Join us for summer camp programs specifically for BIPOC and Black youth! Click here for details about programs open to Black youth, and click here for programs to all BIPOC youth. This year we're offering:
Black Girls Bike Camp
(open to Black-identitfying youth): July 24-28
Black Mermaids Swim Camp
(open to Black-identifying youth): August 25-29
The form below will ask what camps you are interested in!
If you have any needs or questions, contact Reagan (she/her) at reagan@y-we.org
Y-WE Inclusion Policy
*Y-WE centers people who identify as women or girls; were socialized as women or girls; or who were assigned female at birth.
Contact Information
Name
*
First Name
Last Name
What are your gender pronouns? (optional)
she/her, they/them, he/him, etc.
Age
*
Birthdate
*
(mm/dd/yyyy)
Email
*
Verify Email
*
Phone Number
*
Home Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Which program(s) are you applying for? Please visit the Y-WE website for more info about each one .
*
Black Girls/NB Bike Camp (July 24-28)
Black Mermaids Swim Camp (August 25-29)
Will this be your first Y-WE event/activity?
*
select one
Yes, I am new to Y-WE
No, I have been in programs or gone to other events before
How did you hear about Y-WE?
Been in Y-WE programs before
Friend
Teacher or other school staff
Mentor
Parent/Caregiver
Social media/fliers/promotional ads
Other
If you selected 'other' please describe (optional):
What do you hope to get out of the programs you're applying for?
*
What brings you joy in your life?
*
Is there anything you'd like us know about you, your interests, needs, or anything else?
*
Do you have any dietary restrictions or food allergies? (for example: vegetarian, halal, allergic to peanuts, etc).
*
Are there any accommodations you need to make programs accessible and comfortable? (physical space needs, environmental sensitivities, etc)
*
Y-WE is dedicated to creating inclusive spaces and programs for all, including people with disabilities and specific accommodation needs.
Are you generally able to arrange your own transportation to and from these programs/events? If transportation is a barrier, please let us know and we can problem-solve together.
*
Demographic Information
Y-WE collects this data to better understand who we serve, and to improve and obtain support for our programs. Your answers are confidential and will not be shared outside of Y-WE except as part of anonymous percentages.
Do you identify as Black and/or BIPOC?
*
select one
Yes
No
Please share the words you use to self identify your racial/ethnic identity:
*
Gender Identity (select any/all that apply, or select 'prefer not to answer')
*
Agender
Girl or woman
Boy or man
Non-binary
Genderqueer
Transgender
Gender neutral
Two spirit
Cisgender
Genderfluid
Prefer not to answer
Other
If you selected 'Other' please describe (optional)
Do you identify as LGBTQIA+? (select any/all that apply, or select 'prefer not to answer')
select one
Yes
No
Other
Prefer not to answer
If you selected 'Other' please describe (optional)
Please attach a photo of yourself that you like:
*
Parent/Guardian/Caregiver Info
For participants under 18, the emergency contact must be a parent/guardian.
Parent/Guardian Name
*
First Name
Last Name
Relationship to Participant (parent, foster parent, aunt, etc)
*
Parent/Guardian Phone Number:
*
Parent/Guardian e-mail Address:
*
Verify Email
*
Parent/Caregiver(s) Primary Address (if different from youth's home address)
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Please tell us about why you're encouraging your young person to sign up for summer programs, and if there's anything you'd like us to know about them.
*
Y-WE must receive a Medical Form and a Hold Harmless form for each participant in order for them to participate. You will be sent these forms to fill out before the program starts.
*
Thank you in advance for filling out these forms promptly when you receive them!
I understand
Thanks for your application!
