Registration

Registration for Attorney Training
Oct 1-2, 10am-4pm

* Indicates required field

Name *

First

Last

Student Email *

Parent/Guardian Email *

Student Phone *

Parent/Guardian Name *

First

Last

Parent/Guardian Phone *

Student Date of Birth *

Student Pronouns *

Allergies/Dietary Preferences *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Accommodation Requirements (Note taking, visual, hearing, mobility, other) *

Current teams/after school activities *

Grade *

I agree to abide by Valdez Youth Court Confidentiality requirements at all times *

I Agree

I agree to act as a positive peer role model within my community *

I Agree

Submit