Hello Guardian!

Dr. Paula Pilcher, ND, is so excited to announce the Annual Vision Board Party for 2025 and share the excitement of this empowerment program with your teen after seeing its powerful impact on teens since 2013!

The Party is for ages 10-19 and FREE! (Donations appreciated)

It is encouraged to bring a friend or a sibling along, or come alone to make new friends. Everyone coming must be registered with a Guardian's signature, so if your teen is bringing a friend, please be sure they get registered, too.

In order to make it the best experience possible for everyone, this form includes: information about the event, contact info form to register and in case of emergencies, and permissions form to make sure they have everything they need to make the most of their fun and engagement, and keep everyone safe.

 

Please fill out, e-sign, and submit this form before January 25th, 2025 to hold your teen's spot at the party. There is an option to print the form to keep for your own records at the end.

 

RSVP MAX is 100 participants! We will let you know when we receive your registration if we have reached the maximum participants, in which case you will be placed on a waitlist. When we hear of canceled RSVP's we will reach out to let you know that a spot has opened up.

We will be checking registrations at the front door to be sure everyone who enters has been previously registered. Outside doors will be locked to keep everyone safe, but there will be adults at the main entrance door to let people in and account for each teen being picked up by their designated pickup approval.

We will begin letting participants in at 5pm and ask that designated Guardians pick up their teen by 8pm at the latest.

 

The party will be interactive and engaging featuring:

• Vision Board Materials, Magazines and Poster Boards
• Pizza and Snacks
• Soda and Sparkling Waters
• Photo Booth and Props
• Music DJ
• Games Table
• Raffle Prizes
• Vintage T-Shirts (cash donation)
• Slideshow

Fun for everyone!

"Get to know and play with this AMAZING community. You don’t have to have ever been to Empowerteen before, just sign on up and have some fun. Worried about coming by yourself? Don’t be! We’ve got super sweet and friendly high school and college mentors already here to help you feel even more welcomed and accepted for just being yourself! It's what we do."   -Dr. Paula

The Empowerteen calendar of events for 2025 will also be announced at the party, so come on by and be the first to know!

 

This is for newbies and curious peeps, current Empowerteens, and the Empowerteen alumni alike! IT’S A PARTY PEOPLE!!!

 

For questions about the party, or general information, please email us at events@empowerteen.org or give us a call at 503-207-6284. For anything you need Dr. Paula to know specifically about your teen's needs, email her at dr.paula@empowerteen.org.

 

For more information about future events with Empowerteen, please go to https://www.empowerteen.org/events/ to get the latest updates.

 

It is our policy to contact the parent or adult guardian as soon as possible in the event of an emergency. We will contact the Guardian listed above first, then the Emergency Contact, in that order. If we cannot get ahold of anyone after this process, we will activate emergency services by calling 911 if necessary. It is your responsibility to let us know if we need to be aware of potential health issues that may arise as the teen attends this social event, and any modifications that are needed to prevent emergency situations.

 

By hitting submit and signing this form, I agree that I am the parent or adult guardian of the above named teen participant, I am over the age of 18, I take full responsibility for the participant, and all the information entered into this form is true and correct with nothing omitted. I agree that if any of this information changes that I will notify Empowerteen so in writing before the start of the event. In case of medical emergency or general medical care, I give consent for medical teatment for the aboved named teen participant by authorized personnel. I authorize Empowerteen to use my teen's picture, testimony, and video in any promotional material (web, print, or media) unless I otherwise nofity so in writing before the start of the retreat. I will attach a picture of my teen's face in the upload portal below if I want their face blurred or cropped out of pictures taken in this large group setting. I am aware that I will be taking a spot from someone else to attend due to the maximum of 100 participants, therefore if my teen can no longer make it to the event, I will let Empowerteen know at events@empowerteen.org so that they may open the spot to a teen on the waitlist. As the adult guardian I understand the inherit risks involved with this event's activities and social interactions, and I agree not to hold Empowerteen, 11-22 Integrative Medicine, or Dr. Paula Pilcher liable. I am aware that if I do have concerns, that it is my responsibility to have engaged contact with the appropriate parties at Empowerteen to address them. Therefore this signature will also serve as my informed consent and waiver. 

Be certain to enter your email address correctly on the registration form to receive confirmation via email. Once you have signed and submitted, we will contact you via email from events@empowerteen.org to let you know if your spot has been saved or if we've hit the max participants and you will be on the waitlist until a spot opens up. We will also send a final confirmation with any updates a few days before the event starts. Please be looking for it!