Summer SPEAK Registration Form

Summer SPEAK Registration Form

SPEAK stands for SafePlace Peer Education, Action, and Knowledge. It is a group of teens from Thurston County high schools interested in coming together to talk about issues that are important to them. Our two-week summer program focuses on how to take care of ourselves while working to create change in our community.
What does SPEAK do in the summer?

Summer SPEAK meets six times over two weeks in mid-August to talk about self-care, self-love, and sustaining ourselves when doing hard work (whether that's social justice activism or finishing high school). We do art projects, spend time outside, and learn new skills like yoga and mindfulness. We also build community with like-minded peers that can support us outside of SPEAK and when the program is over. Those that participate in Summer SPEAK are encouraged to continue on with the full-year SPEAK program that runs from Fall 2020 - June 2021, but that is not required.
Requirements for SPEAK:
- Must be between the ages of 15 - 18-years-old OR be a high school student in Fall 2020
- Must have a passion for working with peers around issues like relationships, boundaries, consent, and other related topics.
- Must be open-minded, non-judgmental, and want to work with people from diverse backgrounds and experiences
- Must be able to balance other summer activities (sports, family, school work, music, clubs, etc.) with commitment to SPEAK
- Must allow a background check
- Must attend all Summer SPEAK sessions (dates TBA)
Name*

First NameLast Name
Pronouns (e.g. they/them, ze/zir, she/her, he/him, etc.)*
Date of Birth (mm/dd/yyyy)*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
School*
Grade (as of Fall 2020)*
Cell Phone Number*

Area CodePhone Number
E-mail*
Preferred contact method?*

TextEmailCall
Dietary restrictions/food allergies?
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number*

Area CodePhone Number
Parent/Guardian E-mail*
Which SPEAK program are you interested in?*

Full year program (2020-2021)Summer SPEAK 2020Both!
Please answer the two questions below. There is no right or wrong answer, we are just trying to get to know you a little bit as a person:
Why are you interested in Summer SPEAK?*
Why do you think talking about self-care is important?*
Thank you so much for registering for Summer SPEAK!

You will receive a follow-up at your preferred contact method 2-3 days after registering and a detailed agenda two weeks before the program starts. If you have any questions, feel free to email, call, or text Sierra Abrams, Youth Education Specialist at SierraA@safeplaceolympia.org and (360) 791-0860
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Summer SPEAK Registration Form

What does SPEAK do in the summer?

Thank you so much for registering for Summer SPEAK!