RSVP for 2017 Disrupt the Narrative: Youth Leadership Summit hosted by The Representation Project
Are you between the ages of 16 - 24? Are you passionate about challenging and overcoming limiting gender stereotypes and social injustices? Jennifer Siebel Newsom and The Representation Project are hosting the 2017 Disrupt the Narrative: Youth Leadership Summit on August 5th in San Francisco, and we want you to be there! The Representation Project will be hosting a gathering of 250 youth leaders to discuss how we can change the narrative and make positive change in our communities. By the end of the day-long summit, you will be empowered with the tools and resources to even host an inspiring DIY summit in your community!

Where: Lucasfilm Letterman Digital Arts Center (1 Letterman Drive, San Francisco, CA 94129)
When: August 5, 2017 8:30 - 4:30 p.m. PT
Cost: Free (lunch included)

*All attendees under the age of 18 must submit a permission form signed by a parent or legal guardian: https://form.jotform.us/70957859484174

**This event will be photographed and recorded. All attendees must complete a media release form: https://form.jotform.com/62066124679157

If you would like to attend, please complete and submit the following information. Seats are limited and filling up quickly, so we encourage you to apply as soon as possible!

Email address
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First Name
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Last Name
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Date of Birth
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Current City of Residence
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Current State of Residence
Organization Affiliation
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Current School/College/University
(Please write "N/A" if you are not currently in a K-12 school or higher education)
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Gender Identity
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Racial/Ethnic Background
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T-Shirt Size
Dietary Restrictions
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Twitter Handle
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Facebook Username
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How did you hear about the summit?
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I understand and accept the following behavior will not be tolerated at the Youth Leadership Summit: Possession or use of alcohol, tobacco, or illegal drugs. Possession or use of weapons, including pocket knives, firearms, and fireworks. Inappropriate sexual behavior.
Violation of these standards, or being knowingly in the presence of others violating these standards, can and will result in consequences deemed appropriate by the staff of The Representation Project, including, but not limited to, leaving the venue immediately at the participant’s expense.
By participating in the Disrupt The Narrative: Youth Leadership Summit, I am excited to continue the conversation by bringing the summit's mission of inclusion, equity, and youth empowerment back to my community. By utilizing the toolkit and resources The Representation Project will provide, I will continue the conversation in my local community (e.g. screening of Miss Representation and/or The Mask You Live In, facilitate a discussion or even host my own youth summit)!
A copy of your responses will be emailed to the address you provided.
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