TEAL Teen Program Interest

YMCA TEAL Program

Teen Empowerment and Leadership
Please tell us about a bit about you and your interests!
Teen's Name

First NameLast Name
Teen's Age:
A Parent or Guardian's Name

First NameLast Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent's Email
Parent's Mobile
Please enter a valid phone number.Format: (000) 000-0000.
Text Notification Opt-in*
I would like to receive Text/SMS communication from the YMCA
Please tell us about yourself:
Your school name:
Your grade:
Why are you interested in the TEAL program?
Your favorite subject:
Your favorite hobby or sport:
Are you a member of the Y or have you participated in a program at the Y?:
Tell us which programs you have participated in at the Y:
Please select your top three areas of interest:

Other
Please select the YMCA location you prefer:
Lead Source
Lead Event
* By opting in to Text/SMS updates, you agree to receive periodic text messages from the YMCA of San Diego County including but not limited to YMCA account, membership or program activity as well as any indicated areas of interest. You can expect approximately 2-4 non-transaction related messages per month. There is no obligation, and you can opt out at any time by replying with the word "STOP" to any text message received. Standard message and data rates may apply. Your privacy is important to us; see our privacy policy for how we protect and use your data.
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