Secure The Bag Work Sessions

1

Students Full Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Please enter a valid phone number.

4

Current Grade* This field is required.

High School Junior

High School Senior

College Student

5

Name of your School* This field is required.

6

Are you 18 or older?* This field is required.

YESNO

7

Parent’s Name* This field is required.

First Name

Last Name

8

Parent’s Email* This field is required.

example@example.com

9

Parent’s Phone Number* This field is required.

Area Code

Phone Number

10

Which Work Session(s) Are You Coming To?* This field is required.This is a drop in format, you are not required to be present the entire time.

Saturday, September 26th 10a-12:30p

Saturday, October 24th 10a-12:30p

Saturday, November 14th 10a-12:30p

11

Signature* This field is required.I understand that these are drop-in sessions and that I am not required to stay the entire duration of the work session. My transportation and location will be my responsibility to communicate with my parent/guardian if under the age of 18y.o. YMF as an organization & contract staff of YMF are not responsible for coordinating my arrival or departure to the drop-in sessions.