FREE “Your Voice. You Matter.“ Youth Summit--Dallas
Middle and High School students!!!

Date and Time: Saturday, February 1, 2020 from 8:00 a.m. to 3:00 p.m.
Address: CityLab High School (Dallas ISD)--912 S. Ervay Street Dallas, Texas 75201
Contact: Dr. Ro, Director of Education -- drro@thekensingtongroup.org

Earn Community Service Hours and Make a Difference!
Email address *
STUDENT INFORMATION
First and Last Name *
Student Home Address *
School Name and School District *
Grade *
Gender *
Ethnicity *
Special Needs *
Transportation after Summit *
Cell Phone Number *
Email Address *
Emergency Contact Information *
Dietary restrictions *
T-shirt Size *
PARENT INFORMATION
Parent Name/Guardian *
Parent Phone Number *
Parent Email Address *
PARENT PERMISSION
My typed full name below indicates my agreenent to the following:
1. I give my child(ren) permission to attend the "Your Voice. You Matter." Youth Summit at CityLab High School on Saturday, February 1, 2020.
2. All information on this Registration Form is correct.
3. I understand that my child(ren) may be photographed and/or filmed for promotional materials and media.
4. My child will be contacted by Kensington representatives to follow up on Summit Action Plan Goals throughout the semester.
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