Youth Writers Rock Registration Form

Registration Form

Youth Writers Rock Program January 17, 2026 – May 23, 2026 Orokawa YMCA in Towson 600 W. Chesapeake Avenue, Towson MD 21204, Students must pre-register with this form. Registration Email:youthwriterschallenge@gmail.com
Student Name

First NameLast Name
Guardian Name

First NameLast Name
Student Age
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student E-mail
example@example.com
Mobile Number
Guardian E-mail
example@example.com
Guardian Mobile Number
Student Grade Level
Does your student have a laptop they can bring to class?
** Important things to remember**

· Youth Writers Rock Program meets from -January until May

· Youth Writers Rock Program meets every other Saturday from 10:00am until 1:00pm

·       Each student will be required to sign a Behavioral Contract

·       Each parent and student will be required to sign a confidential agreement

·       Each student should bring a laptop with them to class
Additional Comments
Should be Empty: