DICES Teen Night on Denman Island
Please complete this registration form for each individual youth for DICES Teen Night on Denman Island.  Teen Night is a safe space for youth ages 12 to 18 to meet, have fun, and connect with supportive adults. Teen Night starts on Sept. 19 and ends Dec. 19 this term. 
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Youth's name, preferred pronouns and date of birth (youth must be at least 12 years old to attend.) *
Primary Caregiver/Guardian's name, phone number and email *
Additional Caregiver/Guardian's name, phone number and email  *
Please tell us student's medications, allergies, medical conditions, BC Medical Services Number (optional) and an alternative emergency contact.  This information is kept confidential and will be used only in the case of an emergency.   *

DICES Teen Night Agreements

● Take care of yourself

● Take care of others

● Take care of the Hub, Aerie Arcade, Denman Island Community Hall and the outdoor space 

● No alcohol, drugs, fighting or weapons at Teen Night 

Youth are expected to stay once they arrive, unless adults make other arrangements

● As a parent I agree to support my child by reinforcing this agreement and arranging transportation to and from Teen Night every evening. In the unlikely event my child is asked to leave early due to breaching the above agreement, I agree that I will be available or able to arrange to pick them up. 


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Required
Registration is $60/13 weeks until Dec. 19  to cover the costs of staff, snacks, space rental and supplies. I understand that my child must be registered and the fee paid before they start Teen Night. No drop ins. If you require financial support please contact us! *
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