2025 ENRICHMENT - Winter Day Enrichment Programs

Jacob's Chance presents:

Winter Day Enrichment Programs

January 13th - March 7th (8-weeks)

Registration open through January 1st, or until at capacity

These 8-week sessions of enrichment programs are for high school graduates through age 40, focused on exploring new interests and topics through hands-on activities and shared experiences with peers. In these à la carte style programs, try one class, or take them all!

Program selections are removed when capacity is reached. Contact us at programs@jacobschance.org to be placed on our wait list!

Please know that Helping Hands is a field trip based enrichment program and each week will require you to meet at various locations around Richmond and the surrounding counties

In an attempt to serve more families, we ask that you only register your participant for ONE Culinary Arts or Art from the Heart enrichment program

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Financial Assistance is always available

Program desciptions can be found HERE!

*Please double check you selected the correct time slot and program prior to completing the rest of this form*

Refund Policy *

Jacob's Chance is able to process refunds upon request, up to one week prior to the start of the program/session, minus a 10% processing fee.

I acknowledge and accept the terms of the refund policy.

Optional Donation - Support the Mission!

$100

$50

$25

$10

Participant Information

Name *

First Name

Last Name

Birthdate *

(mm/dd/yyyy)

Participant Diagnosis *

Any accommodations requested/helpful tidbits? *

Is there anything we should know about the participant to ensure they have the most success possible? *IMPORTANT* - Per our policies, "we are unable to provide assistance with the following: toileting, wheelchair transfers, feeding, and any other ADLs." If your participant requires this type of assistance, a parent/guardian/caregiver must stay onsite the duration of the program. If you have any questions, please feel free to give us a call!

Does the participant have any allergies? (dietary or outdoor) *

Jacob's Chance will not administer any medication, so any rescue medication must be brought and administered by guardian/participant

Are there any dates you cannot attend? *

Attendance *

I understand that by registering for this program, I am reserving one of the limited spots. I will make every effort to attend each date. If I find that I cannot attend the majority of the classes, I will let Jacob's Chance staff know as soon as possible, so a family on the waiting list can take my spot.

Demographic Data *

Data collection is used only for grant compliance and internal review purposes. Check all that apply

Caucasian

Black or African American

Asian

Indigenous American or Native American

Native Hawaiian or Pacific Islander

Hispanic or Latino

Not of Hispanic Origin

Not interested in reporting

Gender Identity *

Data collection is used only for grant compliance and internal review purposes. Check all that apply

Male

Female

Non-binary

Other

Not interested in reporting

Requested pronouns (examples: he/him, they/them, she/her)

Family Contact Information

Parent/Guardian Name *

First Name

Last Name

Phone *

Email *

Verify Email *

Secondary Email (optional)

Verify Email

Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Policy Agreements/Waivers

Jacob’s Chance requires all participants, family members, caregivers, staff, board members, and volunteers to conduct themselves in a safe and respectful manner to help maintain a comfortable, safe, and fun environment. In order to engage in Jacob's Chance programs, everyone must read thoroughly and agree to the terms established by the documents below.

Jacob's Chance Code of Conduct

Jacob's Chance Program Policies

Jacob's Chance Risk, Media, & Concussion Waivers

I have read fully, and agree to the terms established by the waivers/policies linked above. *

Yes

Name of the person responding to the above waivers/policies, on behalf of the participant registered. *

First Name

Last Name

*Please double check you selected the correct time slot and program prior to proceeding to the payment screen*

Add 3% to my total amount to help cover the payment processing fees

Program Registration *	Quantity
$0 - Music with Brooke (Virtual)
$40 - Helping Hands
$20 - Helping Hands- partial assistance
$0 - Helping Hands- full financial assistance
$128 - Improv with Bridge 9 Theater
$64 - Improv with Bridge 9 Theater- partial assistance
$0 - Improv with Bridge 9 Theater- full financial assistance assistance
$128 - Art from the Heart (TUESDAY)
$64 - Art from the Heart (TUESDAY)- partial assistance
$0 - Art from the Heart (TUESDAY)- full financial assistance
$128 - Music with Andrew
$64 - Music with Andrew- partial assistance
$0 - Music with Andrew- full financial assistance
$40 - Book Buddies with Kasie
$20 - Book Buddies with Kasie- partial assistance
$0 - Book Buddies with Kasie- full financial assistance
$128 - Art from the Heart (THURSDAY)
$64 - Art from the Heart (THURSDAY)- partial assistance
$0 - Art from the Heart (THURSDAY)- full financial assistance
$128 - STEAM with Carol
$64 - STEAM with Carol- partial assistance
$0 - STEAM with Carol- full financial assistance
$0 - Open Mic Karaoke (Virtual)

2025 ENRICHMENT - Winter Day Enrichment Programs

Jacob's Chance presents:

Winter Day Enrichment Programs

January 13th - March 7th (8-weeks)

Registration open through January 1st, or until at capacity

These 8-week sessions of enrichment programs are for high school graduates through age 40, focused on exploring new interests and topics through hands-on activities and shared experiences with peers. In these à la carte style programs, try one class, or take them all!

Program selections are removed when capacity is reached. Contact us at programs@jacobschance.org to be placed on our wait list!

*Please know that Helping Hands is a field trip based enrichment program and each week will require you to meet at various locations around Richmond and the surrounding counties*

*In an attempt to serve more families, we ask that you only register your participant for ONE Culinary Arts or Art from the Heart enrichment program*

*Financial Assistance is always available*

Program desciptions can be found HERE!

Participant Information

Family Contact Information

Please know that Helping Hands is a field trip based enrichment program and each week will require you to meet at various locations around Richmond and the surrounding counties

In an attempt to serve more families, we ask that you only register your participant for ONE Culinary Arts or Art from the Heart enrichment program

Financial Assistance is always available