Skip to content
Youth Summit Registration
Please complete the following form to register for the Equity in Mental Health Fair & Youth Summit on April 11, 2026.
*
1.
First Name
(Required.)
*
2.
Last Name
(Required.)
*
3.
Email
(Required.)
*
4.
Zip Code
(Required.)
*
5.
County
(Required.)
*
6.
Grade Level
(Required.)
9
10
11
12
*
7.
Do you prefer to get messages through social media? If so, which one?
(Required.)
Facebook
Instagram
X/Twitter
Other (please specify)
None of the above
*
8.
What is your preferred social media handle? If you don't have one, write N/A.
(Required.)
*
9.
Does your parent or guardian know you are planning to attend the Youth Summit?
(Required.)
Yes
No
*
10.
Did your parent or guardian provide verbal approval (consent) for you to attend the Youth Summit?
(Required.)
Yes
No
*
11.
How did you hear about this event?
(Required.)
Social media
Friend or family member
Teacher
Community flyer
Career Pathways Program
Other (please specify)
