Youth Empowering Youth: Free Online Leadership Program, Ages 13-18
Days: Sundays
Time: 1:00 - 2:30PM Pacific Time

Session 1: Sunday July 25 2021 - The Ripple Effect
Session 2: Sunday August 1 2021 - Attitude Creates Your Life
Session 3: Sunday August 8 2021 - The Moment You Stop Blaming, You Take Back Your Power
Session 4: Sunday August 15 2021 - Take Action! With Small Steps
Session 5: Sunday August 22 2021 - Fail Forward to Success
Session 6: Sunday August 29 2021 - Drive Your Life with Powerful Habits
Session 7: Sunday September 5 2021 - Be A Student of Life
Session 8: Sunday September 12 2021 - Momentum is Your Responsibility
Session 9: Sunday September 19 2021 - Graduation & Next Steps

Please note that this online program will be recorded for: (1) Internal Use - training and quality assurance; (2) Participant access - for participants who want to review or who miss a class, this feature is only available during the program and recordings are not downloadable; (3) If parent indicates media consent in registration form below, clips may be used for program promotion/testimonials.

Questions?
Contact Mia Takeuchi, YEY Program Coordinator:
mia@lowentropy.org

Website: https://lowentropy.org/youth-empowering-youth/
I commit my youth to attend the full 9-session online program: *
Youth Full Name (First and Last Name) *
Youth Preferred Gender Pronouns *
E.g.) She/Her, He/His, They/Their etc.
Youth Age *
Youth Date of Birth *
MM
/
DD
/
YYYY
Youth Grade *
City You Live In *
Parent/Guardian Full Name (First and Last Name) *
Parent/Guardian Relationship to Youth *
Parent/Guardian Phone Number *
Parent/Guardian Email *
Youth Email *
Do you want emails delivered to Parent/Guardian, Youth, or both? *
What school does the youth attend? *
Any additional information you would like us to know about your youth? (Optional)
How did you hear about this program? *
If you chose "Other" for the previous question, please elaborate:
Media Consent: photos and audio/video recordings may be used to publicize or promote the Youth Empowering Youth Program. I give consent for photos and audio/video recordings of my youth to be taken and used to publicize the work of Youth Empowering Youth. *
Required
Media Consent: first names of youth may be used to publicize or promote the Youth Empowering Youth Program. I give consent for my youth's first name to be used to publicize the work of Youth Empowering Youth. *
Required
Terms and Conditions: These terms and conditions are to be followed by all participants of the Youth Empowering Youth Online Program including parents and children/minors. A parent or guardian over the age of 18 must agree to these terms on behalf of the child (children/youth) participating in the Youth Empowering Youth Zoom platform. The following behavior and protocol must be followed in order to participate in Youth Empowering Youth Program on Zoom. I understand that: *
Required
Parents/Guardians: By typing your name below, you agree to the above conditions and give permission for your youth to participate in this program. *
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