Linking Families & Teens (LiFT) Registration
Date: May 29, 2026 | Time: 10:30am-3:30pm MST | Location: Change Labs (Shopping Ctr, Suite 10 Shiprock, NM 87420)
What to Expect During Training
LiFT will be conducted in-person. Participants (parent/caregiver and teen) should plan to attend the six-hour workshop. Content includes interactive and immersive group work to ensure successful completion and certification.
Parent/Caregiver's Name
*
First Name
Last Name
Relationship to Teen
*
Ex: Mother, father, aunt, uncle, grandparent, older sister, older brother, etc.
Teen's Name (must be between the ages of 13-19)
*
First Name
Last Name
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent/Caregiver's Email
*
example@example.com
Parent/Caregiver's Phone Number
*
CBI staff will contact you if needed.
Format: (000) 000-0000.
Please list all dietary restrictions. CBI will be providing lunch in the afternoon.
*
Parent/Caregiver Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: