Save Our Seats!
The Philadelphia Youth Summit on Opioid Awareness
To reserve seats for your school/organization, please complete the form below.
Please indicate the number of students and teachers/chaperones that will be attending the Summit. It is important to provide accurate numbers as we will be mailing your parking information and tickets to you.
School/Organization Contact Person Name:
School/Organization Address 1:
School/Organization Address 2:
How many members of your school/organization would you like to reserve space for?
(Please remember that you will not receive tickets until all participant permission forms have been received.)
Number of Teachers/Chaperones/Adults Attending:
Number of Students Attending:
Total Number of Attendees Planning on Attending:
Do any of your students or chaperones require special accommodations, i.e., wheelchair access, sign language interpreters?
What type of accommodations does your school require?
Hearing Impaired/ASL Interpreter
How many students require ASL Interpretation?
How many students/teachers require wheelchair access?
How many students/teachers are visually impaired?
What form of transportation will you be using to attend the event?
Will you require parking at the event?
How many cars/buses will you require parking for?
Will you need to leave before the event concludes at 12:30 PM?
Should be Empty: