2020 VIRTUAL Youth Leadership Conference

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2020 VIRTUAL Youth Leadership Conference - Sign Up!

Dates: August 3-7th (Virtually)

Due to the uncertainties of Covid-19, iEmpower will be hosting a virtual Youth Leadership Conference this year! While this program will be offered at no cost to local youth, computer/device and internet access is required. Additional information will be emailed closer to the date of the event.
Have questions? Contact us at (919)280-2192 or iEmpowerNC@gmail.com

Name *

Will your child have computer/device and internet access?

Access to Computer/Device

Access to internet

Access to both

Clear selection

Will you be able to pick up an Activity Package (a package with the materials for each activity) for your child?

Yes

Clear selection

If there is a face-to-face option available for the conference, would you be willing to allow your child to participate (with appropriate safety measures in place)?

Yes

Maybe (if there was more information provided)

Clear selection

Current school *

Grade (20-21 school year)? *

5th grade

6th grade

7th grade

8th grade

9th grade

Parent/Guardian Name *

Parent/Guardian Phone Number *

Parent Email *

How did you hear about the event?

Using the Zoom platform: Participants will engage in safe and supervised Zoom virtual meetings through their computer, tablet, or smartphone. Participants will receive Zoom invites through a parent/guardian's email address to join the meeting each day. Safety precautions (such as requiring a password to enter and disabling screen share as a default) will be to avoid hackers and unregistered guests. I confirm that I have read and understand the following: • Your child(ren)'s image will be transmitted through live video throughout the conference. • Some of the activities may be recorded and used for archival and promotional purposes. * *

I give permission for my child(ren) to participate in the 2020 Virtual Youth Leadership Conference.

I do not give permission for my child(ren) to participate in the 2020 Virtual Youth Leadership Conference

Optional Photo Permission: * *

I give permission for images of my child to be used for iEmpower and/or Pasquotank County newsletters, social media (website, Facebook, etc), or similar uses in which there are displayed photos of the organizations’ activities with students.

I refuse to give permission for images of my child to be used for these purposes.

“Don’t Rush Challenge” Permission: *

I give permission for my child to participate in iEmpower’s TikTok “Don't Rush Challenge” for the Canvas Painting activity. Your child is not required to post on the TikTok platform.

I give permission for my child to submit their TikTok “Don't Rush Challenge” video via email. The final product will be used for iEmpower and/or Pasquotank County newsletters, social media (website, Facebook, etc), or similar uses in which there are displayed photos of the organizations’ activities with students. Your child is not required to post on the TikTok platform.

I refuse to give permission for iEmpower to use the TikTok video of my child for these purposes.

Emergency Contact: In the event of an emergency, I understand that iEmpower, Inc. staff will try to contact me. If I am unable to be reached, iEmpower, Inc. will do their best to ensure the safety and health of my child. I do not hold iEmpower, Inc. liable in the event of an emergency. *Please list below an emergency contact's name and contact information. *

If you have any questions or concerns, please let us know here or you can reach us at iempowernc@gmail.com.

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