Youth Holiday Program Registration Form

    Personal Information
    Parent/Guardian Information
    Emergency Information
    Medical Information


    Helpful Information
    Payment Information

    Registrants may choose one of the following schedule options to pay Holiday Program fees. Thanks to our sponsors, fee assistance is available if needed. We require financial statements for verification, such as proof of income and/or disability related expenses.
    Please contact us at or Youth Services at 214-351-2500 to be considered.

    *NOTE: Payments due once registration is confirmed and no later than one week before admittance.

    I need assistance and will submit the following items to

    • Income verification (recent check stubs of all household income)
    • Number living in household
    • Documents or receipts for related expenses – any out-of-pocket fees for any products or services related to disability

    (providing all of these items ensures we are adequately helping the families who need it most) Thank you for your cooperation.

    Please check before submitting.