Youth Peer Support Group - Registration
Start Date: June 3, 2019
Start Time: 2pm - 4pm
Location: Chapel Hill Public Library - 100 Library Dr, Chapel Hill, NC 27514
Email address *
Youth Name *
Your answer
Preferred Pronoun
Age *
Your answer
Youth Phone Number *
Your answer
Guardian Name *
Your answer
Guardian Email *
Your answer
Guardian Phone Number *
Your answer
Address *
Your answer
I understand that the group meets weekly for 12 - weeks and commit to participation. *
Required
We will be in touch soon to confirm your participation!!!
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