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Youth Participant Name
Parent/Legal Guardian's Name
Parent or Legal Guardian Email Address
Please enter a valid phone number.
Street Address Line 2
State / Province
Postal / Zip Code
How would you like to be contacted?
Tell us about your Youth Participant!
Current Age of youth participant
Current Grade of participant
School District of participant
Which skills would you like them to learn more about? Choose as many as apply;
Social & Emotional Literacy (emotional awareness)
Engage in Social & Emotional Support Classes
Identify, Name and Express emotions as they arise.
Mindful Movement, Yoga
Meditation and Breath exercises
Responsible decision-making skills
Controlling impulse behaviors
Behavioral Awareness & Maturity
What else would you like to share with us??
How did you hear about us?
Faith Based Organization
Housing Authority of Frederick
Boys & Girls Club
We are excited to get to know you! Click here to schedule a consultation.
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Thank you for your time! We look forward to connecting with you!
Each 1 Teach 1, Inc. (email@example.com)
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