Registration for Jan 2021 Retreat for Youth of Color

Contact Details
Youth  Participant





Race/Ethnicity


Parent/Guardian Information for ALL YouthParticipants
This section must be completed by parents/guardians for all participants under 18. If you are 18 years old, please fill out with your information.


Race/Ethnicity


FGC-Affiliated Meetings













About Your Youth Participant
Staff and parents/guardians share responsibility to optimize each participant's opportunity to succeed in the program. In order to create a supportive environment for all participants, it is essential that we know of any youth needs in advance. We are grateful for your support in this matter.
Does the youth participant have any: