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* 1. Full name of the young person who will be attending:

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* 2. Age of the young person who will be attending:

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* 3. Name and contact information of the young person's caregiver:

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* 4. Which Empowering YOUTH Program is the young person registering to attend:

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* 5. Please confirm that you understand the program is delivered over multiple sessions during the school term:

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* 6. Please confirm that we can contact the young person and/or their authorized caregiver to discuss ways about ways to support their participation in the program:

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* 7. Please confirm that both the participant and their authorized care giver agree to this registration:

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