RCEY Registration

RCEY Registration Form

To apply for the River Clinic for Empowered Youth (RCEY), please fill in the form below and upload your signed participation and waiver forms. These documents can be downloaded and printed from the below links:

To be considered for the program, we must receive your application by June 10, 2019. Please keep in mind that preference will be given to applicants that put a serious effort into their application.

  • Please list any allergies you have.
  • Accepted file types: pdf, png, jpg, doc, docs.
  • If you are a minor, please make sure your parent or guardian has signed the form.
    Accepted file types: jpg, png, pdf, doc, docx.
  • You can opt out at any time.
  • By registering for this program, you are agreeing to the terms of our CANCELLATION POLICY.
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Cancellation policy