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Strong Voices Smart Choices Parent Registration form

Thank you for your interest in Strong Voices, Smart Choices, a Cover’d House youth empowerment series designed for teens ages 13–16. This small-group experience is created to help youth strengthen their confidence, communication skills, emotional awareness, decision-making, and understanding of healthy boundaries and relationships.

This registration form helps us learn more about your child and prepare for a meaningful, supportive experience. Please complete the form below to reserve your child’s spot.

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Email *
Parent/Guardian Full Name *
Parent/Guardian Phone Number *
Parent/Guardian Email Address *
 Child’s Full Name *
Child’s Age *
Required
Child’s Grade Level (2026–2027 school year or rising grade) *
Required
Will your child be enrolling in Summer '26, Fall'26 or Spring '27
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What made you interested in enrolling your child in Strong Voices, Smart Choices? *
Which areas would you most like your child to grow in through this experience? *
Required
Please share anything you think would be helpful for the facilitator to know about your child’s personality, learning style, social comfort, or support needs.
Does your child have any allergies, medical needs, behavioral considerations, or accommodations we should be aware of? *
In case of emergency, who should be contacted if the parent/guardian cannot be reached?

Emergency Contact 
Name Emergency Contact Relationship to Child Emergency Contact Phone Number
 *
 I understand that Strong Voices, Smart Choices is a youth empowerment series designed to support teens in areas such as confidence, communication, boundaries, emotional awareness, and wise decision-making. *
I understand that parent participation may be requested for the opening/orientation portion of the series and that consistent attendance helps my child get the most from the experience. *
 Is there anything else you’d like to share, ask, or make note of before the program begins? *
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