PREP 2016 - 2017 Sign Up Form
Currently accepting for the December 27th & 28th session!


Dear Parent of a Hub Teen:

The Bristol Hub Teen Center has been awarded support from the Vermont Department of Health to present a curriculum that builds skills to prevent pregnancy, STDs, and HIV.

The current session will run Tuesday, December 27th from 10AM to 4PM, and Wednesday, December 28th from 10AM to 4PM.

Teens that complete the free program will receive a stipend of $150 through the grant. Although you can take this course more than once during the year, you are only eligible for payment ONCE.

We know that information alone won't prevent young people from having sex, but expect that having accurate information about the consequences of unprotected sex might help teens steer toward abstaining, or not having it without protection. Teens are welcome to participate regardless of whether or not they're regular visitors to the Hub.

We're grateful for the opportunity to offer programming that, although the subjects can be sensitive, can also be empowering and positive to our teens. Your child has expressed interest in participating in this Hub program. While the subject matter of this course is straightforward, it can also be sensitive to some families who may prefer for their teen to experience the education in a different manner or at a different time. For this reason, we ask that the parents of all teen participants acknowledge their support of participation by their teen by signing your digital signature and leaving a contact method below.

If you prefer that your teen be excluded from this program, please contact the Hub staff at (802)453-3678 or rkrushenick@gmail.com

Full Name of Teen
Your answer
Full Name of Parent or Guardian
Your answer
I agree that my teen can participate in this session of PREP
Parent or Guardian's email address
Your answer
Parent or Guardian's telephone number
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms