Unmask Your Potential Youth Summit
Please complete the short registration below for October 10th 2pm.  Be prepared for an afternoon full of fun, fast paced learning and growth.  

With this year being more challenging than ever before, we will focus on keeping your motivation, how to maintain good mental health and strategies to destress when times get tough, hear the teen perspective, build confidence and skills on how to speak publicly, learn about Teen Coalition in Action's drug prevention strategies and how you too can become an advocate for change important to you.  We will have guest speakers from Toastmasters, Philanthropy Tank and Hanley Foundation.

But wait!  There's more!!! Meet teens from around the county and have an opportunity to be a part of our next local commercial.  

Participants will receive up to four hours of community service for their attendance and completion of the post survey.

For questions, email AlexaLee@pbcbhc.org or call 561-301-9975.
Sign in to Google to save your progress. Learn more
Email *
First and Last Name *
Phone Number (so we can contact you about any free  things you earn) *
What is your parent/guardian's full name? *
What is your parent/guardian's phone number?
What is your parent/guardian's email address?
What is your zip code? *
What race(s) or ethnicity does your family identify with?  Please select all that apply
What gender do you most identify?
Clear selection
What school do you attend?
What percentage of Palm Beach County middle and high school teens report not using marijuana in the last 30 days?                                                                                  (FYSAS 2018) *
Teens who vape risk damaging their ____________.
Clear selection
According to the American Heart Association, which deposits more tar in the lungs when smoked?
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Palm Beach County Substance Awareness Coalition.

Does this form look suspicious? Report