Summit registration form

IYMS YOUTH & YOUNG ADULT EMPOWERMENT SUMMIT AND CAREER FAIR

Friday-Saturday, January 24-25, 2025 (Evening meetup, Friday evening)

REGISTRATION FORM

Last name

First name

Are you a youth or young adult attending the Summit (13-25 yrs old)? if yes, how old are you?

No, I am not (please ensure at least ONE youth or young adult is registered and attends with you).

Yes, 13-14 years old

Yes, 15-16 years old

Yes, 17-20 years old

Yes, 21-25 years old

Are you a parent of a youth or young adult attending the Summit?

Yes

No, I am a guest attending to observe. NOTE: If you are a guest attending to observe, please do not attend alone. Please ensure at least ONE youth or young adult is registered and attends with you.

Email Address

Phone Number

Adults, please do not attend alone. We are asking each adult to bring at least ONE youth or young adult to the Summit. Please ensure they are registered. TOGETHER, WE CAN MAKE A DIFFERENCE! Thank you!

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