Bright Futures Registration Form- Summer Program 2024 Survey

Thank you for your interest in YWCA Columbus's 2024 Bright Futures program.

We are so excited for you to learn, grow, and have fun with us this summer.

For many years, Bright Futures has empowered girls and gender-nonconforming youth by shedding light on the social justice issues that impact them and encouraging them to take action.

This year, we are proud to unveil our newly redeveloped version of the program, and we invite you to join our first pilot program. The program consists of a five-part series of Empowerment Workshops focused on social justice and leadership. Through engaging discussions and activities centered around issues like racism, sexism and intersectionality, we seek to up-end insecurities rooted in oppressive ideas and institutions, and equip participants with the tools and knowledge to advocate for social change.

*PLEASE NOTE: You may need your parent/guardian's assistance in filling out this form.

Dates: July 15th-19th, 2024

Time: 1:00-3:00pm

Location: YWCA Columbus (Downtown location)

Bright Futures Registration Form- Summer Program 2024

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* 1. First and Last Name (Required.)

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* 2. What is your t-shirt size? (Required.)

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* 3. Gender Pronouns (Required.)

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* 4. School Name (Required.)

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* 5. Grade (Required.)

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* 6. Date of Birth (Required.)

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* 7. Age (Required.)

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* 8. Participant's Phone Number (Required.)

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* 9. Participant's Email Address (Required.)

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* 10. Race/Ethnicity (Required.)

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* 11. Home Address (Required.)

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* 12. Parent/ Guardian Information (Required.)

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* 13. Family Size (Required.)

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* 14. Household Income (Required.)

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* 15. Are there any allergies that we should be aware of? (Required.)

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* 16. Who is your favorite leader? Why? (Required.)

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* 17. What activities are you involved in the community? (Required.)

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* 18. What is a change you want to see in your community? (Required.)

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* 19. Why do you want to be a part of a leadership and social justice based program? (Required.)

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* 20. How will you be arriving to the program? (For example, driving, drop off, etc.) (Required.)

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* 21. How did you hear about this program? (Required.)

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* 22. Were you referred to this program (Required.)

1. First and Last Name (Required.)

2. What is your t-shirt size? (Required.)

3. Gender Pronouns (Required.)

4. School Name (Required.)

5. Grade (Required.)

6. Date of Birth (Required.)

7. Age (Required.)

8. Participant's Phone Number (Required.)

9. Participant's Email Address (Required.)

10. Race/Ethnicity (Required.)

11. Home Address (Required.)

12. Parent/ Guardian Information (Required.)

13. Family Size (Required.)

14. Household Income (Required.)

15. Are there any allergies that we should be aware of? (Required.)

16. Who is your favorite leader? Why? (Required.)

17. What activities are you involved in the community? (Required.)

18. What is a change you want to see in your community? (Required.)

19. Why do you want to be a part of a leadership and social justice based program? (Required.)

20. How will you be arriving to the program? (For example, driving, drop off, etc.) (Required.)

21. How did you hear about this program? (Required.)

22. Were you referred to this program (Required.)