February Teen Virtual Hangout

Teen Virtual Hangout

Social isolation can be hard for anyone but this can be especially hard for teens who are used to seeing their friends everyday. We want to help! We will be offering a weekly teen hangout trivia or other fun activities. Once you fill out this form you will be added to our weekly email giving hangout times for that week!
Parent's name *

First Name Last Name
E-mail *
I am okay my teen sharing cell phone number or email number with other group participants on the virtual hangout.

Yes No
Participant 1
*

First Name Last Name
Participant 2
First Name Last Name
Participant 3
First Name Last Name
Parental Consent
I give full permission for my child(ren) to participate in virtual hangout conducted by Dillon International, Inc.,("Dillon"). I fully and unconditionally release, remise, discharge and hold harmless Dillon (including its parent entities, affiliates, their current and former officers, directors, members, agents and employees), together with providers of services, host family and volunteers from any and all claims, charges, complaints, demands, actions, causes of action, suits, damages, liabilities and expenses (including attorneys’ fees) however caused, that might arise from my child(ren)’s participation in pre-teen group. I have read, fully understand and consent to the terms and liability release above. I also give my permission to allow any photos taken durng the session to be used for promotional purposes. I understand that Dillon will not put any identifying information in the photo. I have read the terms and liability release above and consent.
Please type your initials to indicate that you have read and accept the above terms. *
Payment
Cost is $20/family for one month access. This includes facilitator fees, virtual platform subscription and content.

Want your teen to attend but cannot pay the fee? No problem, please contact marcia@dillonadopt.com to ask questions about our scholarship program! We never want money to be the reason your teen does not attend!!

Make Secure Payment Note: Our system does not accept American Express.

USD $20 Virtual Teen Hangout

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Street Address
Street Address Line 2
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Postal / Zip Code	Country

Thank you!

We are so glad that your child will be joining us!
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Teen Virtual Hangout

Participant 1

Participant 2

Participant 3

Parental Consent

Payment