Project Unbreakable Summer'24 Registration Form
Unbreakable Minds Coaching, in partnership with Author, Ayesha Edwards, present "Project Unbreakable: Transforming Lives through I.D.E.A.s".   Our dynamic Summer Book Club is for Middle and High School teens to help you embrace your uniqueness, advocate for justice, & take charge of your future. We will collaborate with the author of the novel we are reading to deliver this amazing summer experience to Richmond Youth!

Our Goal: to build participants' fluency and comprehension while focusing on social issues that are of interest to them. This will also provide the awareness, advocacy, agency, and support they need to be change agents in their communities and the world at large.  We seek to foster a spirit of volunteerism where each one teaches one and lifts as they all climb the ladder of communal success. 

Who: Middle and High School Teens
Dates: July 1 - July 19, Monday - Thursday 
Time: 8:30 am - 12:30 pm
Location: St. Thomas Episcopal Church 
What's included: All materials + breakfast and lunch
Bonus: Friday Nights are Parent Night

This program is FREE as it is a part of the City of Richmond’s Gun Violence Prevention Initiative.  Funding is made possible by the American Recovery Plan Act (ARPA)

Kindly complete this registration form By JUNE 28th so your child will not miss out on this amazing opportunity!
If you have questions, please reach out to Yolanda Hall at 804-495-1282 or OR Ayesha Edwards at 516-668-6494 or

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Email *
Name of Teen *
Does your teen identify as: *
Address, City, Zip *
Teen's Date of Birth *
Teen's Race (Check all that apply) *
School teen will attend for 2024-2025 school year? *
2024-2025 Grade Level *
Teen's school ID # (Richmond Residents ONLY)
Has your teen's school identified him/her as an English Language Learner (Is English their second language)? *
Parent/Guardian FULL NAME *
Relationship to Teen *
Parent's Phone Number
Preferred language of communication *
Please provide an emergency contact NAME and NUMBER (someone other that parent completing this form) *
Does your teen have food or medical allergies? *
If yes, please indicate what your teen is allergic to.
Does your teen have any special needs or are there concerns about your teen's social and emotional development you'd like us to know? *
If yes, please explain
How would you describe your teen's personality? *
Range of Household Income  (We ask for this information to get a better understanding of the families we serve and to ensure that resources are equitably distributed across the City of Richmond. Your personal information will not be reported with this number) *
Total number of adults in household (over 18) *
Total number of children in household (18 and under) *
How will your teen be transported to and from Project Unbreakable Summer Camp? (Unbreakable Minds does not provide transportation) *
What do you wish for your teen to gain out of Project Unbreakable? *
Anything else you would like for us to know about your teen?
CONSENT: Please read carefully and check each of the following boxes below and then sign below. * *
Parent/Guardian Name (this will serve as your electronic signature)
Date *
A copy of your responses will be emailed to the address you provided.
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