Child Interest request form

Please be aware CVYR does not provide transportation. We are located 3mi. north of Woodlake


How to fill out this form:

This is our first glance at your child. We want to hear an honest opinion about them. This means we want the good, bad, AND the ugly. Our program is here to mentor kids while improving their skills personally, spiritually, and professionally. We encourage you to fill out this form with these things in mind:


* Fill out this form completely, don’t leave blanks

* Fill this form out with another individual who knows your child. (Second parent, grandparent, teacher, etc.)

* Talk to and involve your child when filling out the “Tell Us About Your child” section

(They may rate themselves differently)

* If there is anything important that we need to know about your child other than what has been asked, please let us know in the very last section