Please select which program(s) you would like your child to attend. Please note that for summer programs an additional application will need to be completed for file.
Medical and Emergency Contact Information
How did you hear about us?
Note to Parent
Youth participation in Diamonds On The Rise programs is likely to produce positive outcomes when youth
engage in more than one of our programs and consistent with services. Diamonds On The Rise staff welcomes
high levels of youth participation in all programs as well as special programming
I have read and spoke with staff about polices and procedures of the organization and have
completed the application. I understand the rules of Diamonds On The Rise and request
that my son/daughter/ward be admitted into the program. I have explained the rules to my
son/daughter/ward and agree that Diamonds On The Rise will not be responsible for any
accident to the boy/girl while on the Diamonds On The Rise premises or while engaged in
any of its activities away from Diamonds On The Rise. I understand and agree that my
child (or ward) must be picked up by closing time or a fee will be charged. Fees must be
paid before the child can attend the next session. I give my consent for photographs or
videoing taping in which my son/daughter/ward may appear, to be used in any way the
Diamonds On The Rise may care to use them as long as it is consistent with the Diamonds
On The Rise mission.
By submitting this form, you consent to all above rules and permissions. We look forward to working with you and your child!