Teen Summit

Button: AA County Homepage

Button: AA County Government

Button: AA County Businesses

Button: AA County Residents

Button: AA County Visitors

Button: AA County Employment

Button: AA County News

Button: AA County Events

Google Search

Home > Teens In Partnership > Teen Summit

Email

Print

Teen Summit - Student Registration Form

By registering today, I commit to attending the Teen Summit on May 30, 2009 from 9:00am - 1:00pm. I realize that if I arrive later than 9:30am, I will NOT be eligible to receive my 4 Community Service Learning hours and will NOT be eligible for any prizes given out at the event. Because I have registered for the Teen Summit, I will receive a coupon for a free lunch at the "Choose to Be Drug Free" Recreation and Resource Fair that will held from 1:00pm - 4:00pm. Coupons will be given out at the Teen Summit Registration table.

Upon submission of your registration, you will receive an email confirmation of your registration.

*All fields must be completed to register. Type "NA" if information is not available.

First Name:

Last Name:

Grade:

Age:

School:

Home Address:

City:

Zip:

Home Phone:

Cell Phone:

Student Email: *

Parent/Guardian First Name:

Parent/Guardian Last Name:

Parent/Guardian Email:

Parent/Guardian Cell Phone:

Choose your Teen Summit breakout session:

Please Select One:

Do you have (or if parent registering student) or does your child have any conditions we should be aware of including medical, psychological or behavioral conditions, medications, dietary restrictions, allergies, or special needs?

Please Explain:

Check here if you are over the age of 18 and would like to serve as a volunteer for the Anne Arundel County "Choose to Be Drug-Free" Day Recreation and Resource Fair to be held immediately following the Teen Summit and Parenting Workshops from 1:00 pm - 4:00 pm.

I would like to volunteer

Anne Arundel County, MD. 44 Calvert Street Annapolis, MD. 21401 | Telephone: (410) 222-7000 | Suggestions | Disclaimer
Copyright 2008; All rights reserved