Let's Kick It! Registration
Hi there!

And welcome. This is the registration page for the 4th annual National Youth HIV & AIDS Awareness Day celebration! Please take a moment to fill-out this form with some brief information, so that we can assure we provide the greatest experience possible.

On behalf of the entire NYHAAD team, we couldn't be more happy to see you there!

Full Name (whatever you go by) *
Your answer
Date of Birth (age is just a number lol) *
MM
/
DD
/
YYYY
Zip Code (of where you live) *
Your answer
Phone Number (the one you use to text)
Your answer
Personal Email (the one you actually check)
Your answer
Sexual Orientation
Your answer
Gender Identity
Your answer
How did you hear about the event? *
What aspects of the event are you most excited for? *
Required
Any Questions, Comments, or Concerns? (come on, we know you have some)
Your answer
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