Gifts
Seminar
Venita's View
1.How to communicate effectively so that you are understood.

2.Seven habits of successful teens.
Registration Form
Name:
Date of Birth:
Address:
City:
ZIP Code:
Parent/Guardian:
Home/Cell Phone:
Address of parent if not the same as teen’s physical address:
How did you learn of Leadership Training Day in Orlando, Florida will be held on Saturday, June 26, 2010. Circle the following that applies: Business and Professional Women of Florida member, newspaper article, direct email communication, through a human service organization: Pace Center for Girls, a domestic violence center or other?
Emergency contact:
Daytime Phone:
Emergency contact1:
Daytime Phone:
Email address for parent/guardian:
Second email address if available:
Does your child have any medical conditions that may affect their ability to participate in a one day workshop or that staff/volunteers will need to know about including allergies?
Yes
No
If yes, please describe:
Please list any medication that your child will need to take
during the one day workshop?
Name of teen’s doctor:
Doctor’s phone number:
Are there any activities that your teen may not participate? Such as water activities?
Yes
No
If yes, please state those activities:
Does your teen know how to swim?
Yes
No
Participant’s Name:
Do you have a nickname that you want to be called:
Yes
No
If yes, what is the nickname?
List two things that you like about yourself:
1.
2.
Finish this statement: “Something most people do not
know about me is
Finish this statement: The funniest thing that has ever
happened to me is
From the list of workshop/seminars that the staff of the
Garvin Valdez Group can offer, please list your first and
second choice of workshops that are of interest to you.:
1.
2.
3.
What do you hope to gain from this one day workshop
experience?