2024 'POWERED UP' Youth Symposium Registration Form

The Gwinnett D9 organizations are proud to host the 2024 Powered Up Youth Symposium. This event is designed to empower our youth and provide them with the tools and knowledge to navigate life's challenges. Through engaging discussions and interactive sessions, students will explore topics such as safe social media practices, financial literacy, and teen dating.

We invite parents to join us for the Narcan training in the afternoon, while the students will attend two mandatory sessions: 'Surviving the Kickback' at 12:00 pm and 'Narcan' training at 12:30 pm, as we collectively work to build a safer and more informed community.

Join us on Saturday, October 5th, at Archer High School for a day of learning, growth, and empowerment!  

Event Location: 2255 New Hope Rd, Lawrenceville GA 30045
Event Time: 9:00AM - 2:00PM

Complimentary breakfast pastries, lunch, and refreshments will be provided. The event is free for students ages 11-18, but registration is required.

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Email *
Student (Email Address) *
Student (First Name)  *
Student (Last Name)  *
Student (Age) *
School Name *
Grade in School *
Parent/Guardian (First Name)  *
Parent/Guardian (Last Name)  *
Parent/Guardian(Email Address)  *
Parent/Guardian(Phone Number)  *
Workshop Selections (Choose Only One)  *
Workshop Selections (Choose A Second Option)  *

Media Release Parent Consent Confirmation

If you are under the age of 18, a parent or guardian must provide consent for media release.

Individuals will not be identified or named in any photo unless prior written consent is obtained. Do you, as the parent or guardian, give permission for photos and videos of your child to be taken and used for media and promotional purposes by the event organizers? 

 *

What Do You Hope to Gain?

Which workshop or topic are you most excited about, and what do you hope to take away from the 2024 Powered Up Youth Symposium?

 *

Additional Comments or Questions

Is there anything else you would like to share or any questions you have about the event?

A copy of your responses will be emailed to the address you provided.
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