Thank you for your interest in Bounce™. Please note the information collected for your child is only for intake purposes. Completing this form does not guarantee a placement in the Bounce™ program. If you have any questions or concerns, please email us at programs@wellspringmiami.org or call at (305)722-5380.

A Wellspring Counselor will reach out to the contact person to discuss the appropriateness of the youth for the program and to answer any questions.

All information gathered will be kept confidential under HIPPA guidelines. *County funds available on a first come first serve basis.