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Summit Registration : January 11, 2020 at Langston Chapel Middle School
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Student's First Name
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Student's Last Name
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Student's Age
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Gender
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Female
Male
Emergency Contact Name
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Relationship to Student
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Emergency Phone Number
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Emergency Contact #2
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Emergency Phone Number
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Relationship to Student
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Select the four sessions you would like to attend
Socio-Emotional Well-Being (Learning to manage/process anger for positive results)
Socio-Emoitonal Well-Being (Stress Management/Conflict Resolution)
Socio-Emotional Well-Being (Honoring and creating your best self)
Socio-Emotional Well-Being (Mental, Physical Health and Wellness i.e. meditation/yoga)
Socio-Emotional Well-Being (Mental, Physical Health and Wellness i.e. dance fitness)
Socio-Emotional Well-Being (Mental, Physical Health and Wellness i.e. Glow Stick Special)
Socio-Emotional Well-Being (Get Fit Challenge)
Servant Leadership (Develop Leadership Skills)
Servant Leadership ("Adjust your Crown" Female Talk)
Servant Leadership (Service and Self Transformation)
Servant Leadership (Male Empowerment) Panel Discussion
Servant Leadership (Female Empowerment) Panel Discussion
Artistic Expression (Art and Self-Expression)
Artistic Expression (Poetry Jam)
Life Skills 101 (Self-Identity/Self-Awareness)
Life Skills 101-(Entrepreneurship/Financial Literacy)
Life Skills 101 (Soft Skills Training)
Social Safety (Safety Awareness in relation to social media)
Social Safety (The impact of bullying and unlawful usage)
Other:
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