Youth Empowerment Summit Registration - 4/23/16 Thank you for your interest in this year's Youth Empowerment Summit! Please fill out the information below to register. If you have any questions, please contact Najid Figuera at nfiguera@LUK.org or 978-829-2422.Youth Empowerment SummitSaturday, April 23, 20168:30 am to 3:30 pmBoys and Girls Club of Fitchburg & Leominster365 Lindell Ave. Leominster, MA 01453 Question Title * 1. Contact Information Name School Age Grade City/Town Email Address Phone Number Question Title * 2. Parent/Guardian Contact Information (In case of an emergency) Name * Relationship to Student * Phone Number 1 * Phone Number 2 Question Title * 3. Workshop 1 - Please rank your top three choices by typing the number if the box provided. For example, if Hip-hop is your first choice, type 1, if Culinary is your second choice, type 2, etc. Basketball Hip-hop Culinary Art 1 (ages 13-15) Art 2 (ages 16-18) Cosmetology Barbering College Prep - FSU College Prep - MWCC Healthy Relationships Dating Game US Army APP Invention Workshop OUI Workshop Question Title * 4. Workshop 2 - Please rank your top three choices by typing the number if the box provided. For example, if Hip-hop is your first choice, type 1, if Culinary is your second choice, type 2, etc. Basketball Hip-hop Culinary Art 1 (ages 13-15) Art 2 (ages 16-18) Cosmetology Barbering College Prep - FSU College Prep - MWCC Healthy Relationships Dating Game US Army APP Invention Workshop OUI Workshop Done