Registration form for Threads Of Strength
Threads of Strength is the foundation of the program, focused on awareness, emotional safety, and self-expression.This virtual group creates a supportive space where youth engage in guided sessions while working toward the creation of a personal piece of art that reflects their journey. Throughout each session, participants explore themes such as boundaries, safety symbols, identity, empowerment, and self-worth.
Organization Referring
Organization Name
First and last name
Youth name
First Name
Last Name
Age?
*
Guardian Name
*
First Name
Last Name
Guardian Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Guardian Email
*
example@example.com
Emergency Contact
*
First Name
Last Name
Emergency Contact phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Has the participant been part of any support or creative programs before?
*
What interested you in this program?
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I understand this is a 6-week virtual program meeting weekly.
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Program Fee: $50–$100 (supports materials, supplies, and program development)No youth will be turned away due to inability to pay. This fee helps cover: materials, supplies, program resources, creative tools, and overall program support
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Program or guardian is able to pay the program fee
Program or guardian may need financial support
Program Commitment: This is a 6-week virtual program held on Wednesdays from 6:00 PM – 7:30 PM on the following dates:May 13, May 20, May 27, June 3, June 10, and June 17.
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Yes, I can commit to attending all sessions
I can attend most sessions
I am unsure about my availability
Submit
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