Fight For the Future of the Philippines Summer Program Registration Form
Kabataan Alliance X FYRE Summer Program is an exploration into our Filipino identity and a call to fight for our future. This program is an in-person series of educational workshops taking place every Friday August 13, 20, and 27. Please fill out this form to if you are interested in receiving updates for our program as space may be limited!

We will be following a COVID protocol during our in-person session. Updates on this protocol will be sent via email.
Sign in to Google to save your progress. Learn more
Name (First & Last) *
Who is filling out this form? *
Email Address *
Phone Number
When is your birthday? *
This summer program is for youth ages 14-22.
MM
/
DD
/
YYYY
Zip Code *
How did you hear about this summer program?
What is the best way to reach you with announcements and details about the summer program?
e.g. email, phone call, text
Emergency Contact Name and Relation *
e.g. Mary Jo Silas (Aunt)
Emergency Contact Phone Number *
Which session(s) are you be interested in joining? (We plan on working on a cumulative project throughout the program and recommend joining us for the whole series) All dates are 2-6pm at Othello Park. *
Required
Will you need any help with transportation? *
Let us know how we can assist in carpool options or bus passes!
Do you have any dietary needs/restrictions? *
Any additional information you would like us to know?
If you are under 18, please enter parent/guardian initials to verify that you have permission to participate. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms