Teen Empowerment Summit 2025
Saturday, November 22, 2025 | 10:00am - 2:00pm
Colonial Forge High School
500 Courthouse Rd. Stafford, VA 22554
PARTICIPANT INFORMATION
Student Name:
First Name
Last Name
Student School:
Student Age:
Emergency Contact Name:
*
First Name
Last Name
Emergency Contact Mobile Number:
*
Please enter a valid phone number.
Email:
example@example.com
YOUTH GROUP INFORMATION
Name of Group:
Group Leader Contact Name:
First Name
Last Name
Group Leader Phone:
Please enter a valid phone number.
Number of Middle School Students Attending:
Number of High School Students Attending:
PAYMENT INFORMATION
Select a Lunch Option Below:
Lunch Payment Information (Please select one):
*
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Individual Lunch Payment
Chick Fil-A Lunch Box ($12.50 plus fees)
$
13.46
Bring Your Own Lunch (Indiviudual)
$
Free
Group Lunch Payment (Youth Group)
Chick Fil-A Lunch Box ($12.50 plus fees)
$
13.46
Quantity
Bring Your Own Lunch (Youth Group)
$
Free
Quantity
Submit Registration
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