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Registration Page for the Empowering YOUTH Program
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1.
Full name of the young person who will be attending:
(Required.)
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2.
Age of the young person who will be attending:
(Required.)
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3.
Name and contact information of the young person's caregiver:
(Required.)
Name
Email Address
Phone Number
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4.
Which Empowering YOUTH Program is the young person registering to attend:
(Required.)
Alice Springs:
No programs scheduled at present.
Darwin:
School Holidays 1:00 pm to 4:00 pm.
24, 25, 26 & 27 June 2024.
Crest NT, Unit 3A/66 Coonawarra Drive, Winnellie.
Palmerston:
Saturdays 2:30 pm 5:30 pm.
25 May & 1, 8 and 15 June 2024.
Community Room, Palmerston Library.
Katherine:
Saturdays 12:30 to 3:30 pm.
25 May & 1, 8 and 15 June 2024.
The Y, Henry Scott Recreation Centre.
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5.
Please confirm that you understand that programs are delivered over multiple sessions during either the school term or school holidays:
(Required.)
I understand
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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:
(Required.)
I agree
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7.
Please confirm that both the participant and their authorized care giver agree to this registration:
(Required.)
young person agrees
caregiver agrees
