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Multigenerational Male Empowerment Summit - Registration Questionnaire
1.
Full Name:
2.
Age Group:
o 14-18
o 19–24
o 25–35
o 36–49
o 50–64
o 65 and up
3.
Email Address:
4.
Mobile Number:
5.
Emergency Contact Name and Number (for youth participants):
6.
How did you hear about the MME Summit?
o Church / Ministry
o Family or Friend
o Social Media
o Community Center
o School
o Other: _____________
7.
What is your interest in attending?
Fellowship & Brotherhood
Mentorship
Personal Growth & Empowerment
Fatherhood / Family Engagement
Leadership Development
Support & Accountability
Just Curious / Exploring
8.
Would you be interested in participating in future male-focused groups or mentoring activities?
Yes
No
Maybe
9.
Do you have any dietary restrictions or accessibility needs?