LGBTQIA Youth Group 2021
Thank you for your interest in BRiDGES LGBTQIA++ Youth Group! We are currently meeting virtually, over Zoom, from 7-8pm on Thursdays. This information is just for us (so we can make Youth Group work for you) and will not be shared with anyone else
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What is your preferred name? *
What is your birthdate? *
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DD
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YYYY
Do you think you might want to celebrate your birthday at youth group? *
What grade are you in? *
What school do you go to? *
What pronouns do you use? Pick any that apply (if you use other pronouns, please let us know what they are) *
Required
What is your preferred method of contact? *
Required
Please include your preferred contact information (phone number, email, text number etc) here so that we can send you the Zoom link before Youth Group meetings *
What is your racial identity or ethnicity?  (white, Black, Native American, biracial, Polish, Latinx, etc) *
How do you identify your gender? (if you pick other, please explain) *
Is that the same as the gender you were identified with at birth? (For example, if you were told you were a girl (or a boy) when you were born, does that still feel like who you are?) *
Who is your emergency contact? (please provide name, relationship to you, and a phone number for your emergency contact- must be an adult, over the age of 18, preferably your parent or guardian, or someone who can contact your parent or guardian if necessary) *
What would you like us to call you if we speak to your emergency contact? (if you have changed your name and pronouns, but your emergency  doesn't call you by your preferred name, please tell us what they call you, and what pronouns they use, so they will know who we are talking about) *
What is your mailing address? (please include your first and last name because from time to time we might want to mail out or drop off  some fun stuff at your house, and we want to be sure that it gets to you) If your mailing address and street address are different, please include both. *
Is there anything else that you want to share with us? (like your favorite color, or food, or pet, or book, or TV show, or movie) *
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