RSVP: FREE Virtual Wellness Workshop Series

RSVP: FREE Virtual Wellness Workshop Series on August 5th, 2025 @6 PM - 7:30PM

This virtual wellness workshop is hosted by Passaic County Youth Task Force & NJ RISE Youth Advisory Board!
Registration Form for FREE Wellness Workshop Series

Welcome! Please complete the form below to register. This workshop series was developed by the youth participants of the Passaic County Youth Task Force and the NJ RISE Youth Advisory Board. All New Jersey Teens are invited to attend. Please extend this invitation to your friends, cousins, and siblings. All New Jersey TEENS are welcome to attend FREE WORKSHOP!!!!
Name

First NameLast Name
Email
example@example.com
Student's Age
What county do you reside in? (Ex. Hudson County, Passaic County, Bergen County or others.)
Will you be attending the Virtual Wellness Series Workshop on August 5th, 2025 from 6 to 7:30 PM?

YesNo
Which workshop are you most interested in attending from 6:15 PM to 7:15 PM (1 hour)?

Practing Self-Care (ZOOM ROOM 1)
Virtual Wellness Workshop Series: Release, Waiver, & Indemnification

The Lindsey Meyer Teen Institute, a program of Partners in Prevention, is facilitating a virtual wellness workshop series being hosted by our youth advisory board in Passaic County and Hudson County.
I, the undersigned, hereby give my child permission to attend the Virtual Wellness Workshop Series on August 5, 2025 via zoom from 6 to 7:30 PM. I understand that Partners in Prevention/LMTI staff will be present and that after that time, my child will be dismissed from the programming virtually.

I give permission for photographs/video footage to be taken of the participant, and for photographs/video footage in which the participant is included to be used for purposes of publicity by LMTI, Partners in Prevention, and Passaic County Department of Human Services, Division of Mental Health and Addiction Services.This includes publication of pictures/video on LMTI websites social media outlets.
Parent/Guardian Full Name

First NameLast Name
Relationship to Participant
Parent/Guardian Phone Number
Please enter a valid phone number.
Parent/Guardian Email
example@example.com
Signature

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Date

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Date
***ZOOM LINK FOR EVENT

https://pipnj-org.zoom.us/j/91981403453?pwd=1ZCWMpbQrzE7dISEYb2EOZGjFkqzBL.1
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RSVP: FREE Virtual Wellness Workshop Series on August 5th, 2025 @6 PM - 7:30PM

Registration Form for FREE Wellness Workshop Series

Virtual Wellness Workshop Series: Release, Waiver, & Indemnification

***ZOOM LINK FOR EVENT