Safe Dates Registration Form
Enter participants name and age, & the adults phone number and email address
Safe Dates is a nationally recognized Healthy Relationships Curriculum. SAFE Project advocates have been trained to facilitate the 8-10 week curriculum and hold a safe space for youth to discuss friendships, dating, and family relationships. The sessions will run from September 1st 2026-November 3, 2026.
Full Name
*
First Name
Last Name
Age
Adult Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Adult Email
example@example.com
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Release Waiver
Please review and sign to acknowledge the parent/guardian letter below and Safe Dates family newsletter linked here: https://drive.google.com/file/d/11s9pkUj2ThiMbGXGSoz7SmnfysUYmjZW/view
Release Waiver
*
Signature
Register
Register
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