Black Appalachian Young and Rising Registration
We are excited to announce to you the first Black Appalachian Young and Rising Gathering November 8th-10th at the Pine Mountain Settlement School in Pine Mountain, KY. We hope you can join us for what promises to be a weekend full of fun, friendship, collective learning and growth. Registration will close Sunday, October 27th with a maximum of 60 attendees. Please take a few moments to fill out the questions below with as much detail as possible to help us give you the best experience possible.

This event is only for Black youth between the ages of 14-30 from throughout the Central and Southern Appalachian region- if you have any questions about this please feel free to reach out to us at mekyahdavis.stayproject@gmail.com or stayproject@gmail.com.

Black Appalachian Young and Rising is also committed to creating inclusive and safe spaces for all participants with various experiences within the Appalachian region. Any personal identification information that we are asking (but may not be requiring) is to allow us to make sure we are honoring this commitment to represent and create space for young Black people from the region, regardless of gender, class, sexual orientation, abilities, or background.
Email address *
Name *
Your answer
School/Organization (if applicable)
Your answer
Address, City, State, Zip Code *
Your answer
Phone Number
Your answer
Gender Pronouns
Your answer
Birthday *
MM
/
DD
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YYYY
Race/Ethnicity *
Your answer
Do you identify as LGBTQIA+?
Economic Class
Your answer
Dietary Restrictions *
Required
Do you have any specific needs?
ie: ASL or Spanish Translator
Your answer
Do you need childcare?
We do not want childcare to be a barrier to you attending the summer institute, we will provide childcare if needed and children are welcome to participate in any part of the institute. If you do need childcare please tell us for what ages.
Your answer
Tell us a little bit about your area(s) of interest/work.
Your answer
What do you hope to gain from the Black Appalachian Young and Rising Gathering
Your answer
What do you most look forward to about gathering with other black youth from Appalachia?
Your answer
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