The Three M's: Leadership Academy Registration Form

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Thank you for expressing interest in registering your child in our program. The Three M's is a nonprofit organization in North Carolina designed to work with youth, ages 11-15, to ensure they become outstanding leaders in their schools, communities, careers, and the world.
The Three M's offers workshops on leadership development for middle and high school students (6th-9th grade.) We provide leadership training, financial literacy learning , and resources to both boys and girls in North Carolina.

Please take a few minutes to fill out our registration form. Someone will be in contact with you regarding your standing with our program and further instructions.

Contact us at info@thethreems.org

Rolling Admission to Program

Child's Full Name *

Grade *

Date of Birth *

YYYY

Gender *

Female

Male

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Other:

School *

Primary Language *

Ethnicity *

Parent/Guardian Name *

Parent/Guardian Work # *

Emergency Contact name and number *

Email Address *

What do you hope your child can gain from The Three M's: Leadership Academy? *

I give permission for my child to be in pictures/videos *

Yes

Any allergies? *

I am the parent/legal guardian of the child named above and I give permission for my child to attend and participate in all activities of The Three M's program. I hereby release The Three M's program, its staff, and volunteers of any liability in the event of accident or injury, and I indemnify them for any liable claims that arise against them from such activities. Additionally, I understand that if my child can not attend all three days, I will notify the program. *

Yes

Required

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