Youth Wellness Day Event Registration
Please fill out the form to register for the youth wellness event.
Youth Wellness Day
Join us for Youth Wellness Day at Rio Grande Wellness Center in Del Norte, CO on May 30, 2026 from 8:00 AM–5:00 PM. This free event is for youth ages 13+ and focuses on mental health awareness, coping skills, and community connection. FREE FOOD + GIVEAWAYS.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Birth
*
-
Month
-
Day
Year
Date
Age
under 13
13 +
18 +
50 +
Parent/Guardian Name (if under 18)
Parent/Guardian Phone (if under 18)
Emergency Contact Name
Relationship
Emergency Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What grade are you in?
What school/organization are you with?
Do you have any dietary restrictions or medical conditions/accessibility needs we should be aware of?
Photo & Media Consent
During this event, photos and/or videos may be taken for the purpose of promoting future youth programs, community outreach, and reporting to partners or funders.
Do you give permission for the participant to be photographed or recorded during this event?
Yes, I give permission for photos/videos to be used for promotional and educational purposes
No, I do not give permission for my child to be photographed or recorded
“I understand that: photos/videos may be used on social media, websites, flyers, and reports. No personal identifying information (such as last names, contact info, or sensitive details) will be shared. I can withdraw consent at any time by contacting the event organizers”
What topics are you most interested in? (Check boxes)
Stress Management
Anxiety & Depression Awareness
Coping Skills
Social Media and Mental Health
Self-Care
Peer Support
Consent Agreement
I give permission for the participant to attend this event and understand it includes wellness education and activities.
Register
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