Good Medicine Series Registration Form

Good Medicine Series Registration Form

Good Medicine Series 2025-26 - Youth and Families ages 12 and up
Youth Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Tribal Affiliation (Background)
Gender
Parent/Guardian Name

First NameLast Name
Tribal Affiliation (Background)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student E-mail
example@example.com
Mobile Number
Format: (000) 000-0000.
Parent E-mail
example@example.com
Parent Mobile
Format: (000) 000-0000.
Applique ClassMedicine BagsCedar WrappingSweetgrass BraidingMaking Medicine SalvesMedicine Tinctures MakingSage Spray MakingJewelry Making Beargrass EarringsRibbon Skirts/ShirtsRed Lightning Young Womens Summer virtual 6 part seriesTalking CirclesSweatlodgesSacred Bundle Suicide Prevention Screeners (Recieve a $25 giftcard upon completion)Indigenous Evaluation TrainingBehavioral Health Screenings, Counseling, Therapy ReferralAll of the Above
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