Virtual GEM Summer Camp
Event Timing: weekly
Event Address: online
Contact us at (615)768-9891 or jdouglas@empowerteens.org

Please complete the registration form below to secure your spot. You can register up to 5 individuals on the same form if they will be using the same computer. Please complete additional forms for additional participants so we can track the number of accesses as space is limited.
Email address *
Parent/Guardian/Responsible Adult Name *
Parent/Guardian/Responsible Adult Email *
Organization
Participant #1 Name *
Participant #1 Email *
Participant #1 Age *
Participant #1 Grade *
Participant #1 attends school in... *
Participant #2 Name
Participant #2 Email
Participant #2 Age
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Participant #3 Name
Participant #3 Email
Participant #3 Age
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Participant #3 Grade
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Participant #3 attends school in...
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Participant #4 Name
Participant #4 Email
Participant #4 Age
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Participant #4 Grade
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Participant #4 attends school in...
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Participant #5 Name
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Participant #5 Grade
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