Youth Registration

Each One Teach One Youth Conference Registration Hosted by Heart & Soul Foundation

Thank you for registering for the Each One Teach One Youth Conference. This two-day empowerment experience is designed to inspire, equip, and uplift youth through mentorship, leadership development, and life skills training.May 29th & May 30th | 10:00 AM – 4:00 PMHeritage Hall @ IGBO Community Center | Phoenix, Arizona
This conference is designed for youth ages 13–18 (8th–12th grade).

This is a supervised drop-off event for registered youth ages 13–18.
- Youth Name*
  
  First NameLast Name
- Date of Birth*
  
  MonthDayYear
  Date
- Age*
- School Name
- Grade Level
- T-Shirt Size
- Name*
  
  First NameLast Name
- Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- Email*
  example@example.com
- Emergency *
  
  First NameLast Name
- Emergency Contact Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- No, they must remain on-site.Yes, with parent notification.Other
- Yes, I plan to remain on-site as a guest (food not included).No, I will drop off and pick up.
- Does your child have any dietary restrictions?Options:NoneVegetarianVeganGluten-FreeDairy-FreeNut AllergyOther (Please specify)*
- Lunch and light refreshments will be provided to registered youth participants on both days of the conference.
- Please note: Meals and refreshments are provided for registered youth participants only. Food is not guaranteed for parents or guardians who remain on-site.
- Allergies*
- Medical Conditions*
- Special Accommodations Needed*
- I give permission for my child to participate in the Each One Teach One Youth Conference hosted by Heart & Soul Foundation. I understand this is a supervised event. I authorize emergency medical treatment if necessary. I also grant permission for photographs and video to be used for promotional purposes.
- yesno
- Signature*
  
  Powered by Jotform SignClear
- Date*
  
  MonthDayYear
  Date
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Each One Teach One Youth Conference Registration Hosted by Heart & Soul Foundation

This conference is designed for youth ages 13–18 (8th–12th grade).