Empowering YOUTH Program Registration

The Empowering YOUTH Program is run over 4 half days. These July School Holidays we will be in Katherine and Alice Springs. Register to attend here. To find out more about the program go to the webpage.

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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:

Name

Email Address

Phone Number

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

Katherine Workshop:
9 am to 12 pm on Mon 27 June, Tue 28 June, Wed 29 June and Thu 30 June

Alice Springs Workshop:
9 am to 12 pm on Tue 12 Jul, Wed 13 Jul, Thu 14 Jul and Fri 15 Jul

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* 5. Please confirm that you understand the program is delivered over four sessions:

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:

I agree

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

young person agrees

caregiver agrees