Sign-up Form

We are super happy you decided to become a member of our community of teens!

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* 1. Your contact information (First Name/Last Name)

Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Email Address *

Mobile Phone

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* 2. Date of Birth (MM/DD/YYYY)

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* 3. If you're under 18, we need your parent(s) / guardian info because they must sign a waiver. We won't contact them after. Give Us The Floor is a safe and supportive place for teens, we will never contact your parents unless you're in danger.

Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country *

Email Address *

Phone number

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* 4. T-shirt size

2XL

3XL

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* 5. Your Social Media handles (Optional)

Snapchat

Instagram

Youtube

Twitter

Facebook

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* 6. Would you like us to follow you?

Yes, please

No, thank you

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* 7. How did you hear about us?

Google search (or other search engine)

Event

Twitter

School

Friend(s)

Youtube

Youth organization

Instagram

Snapchat

Facebook

Other (please specify)