Registration Girls Empowerment Group Tuesday, Oct 1, 2024 – Tuesday, Nov 5, 2024 3:30pm – 4:30pm Event Location Tri-Town Youth Services, 56 High St.Deep River, Connecticut, 06417 Event Fees FREE REGISTER School * Chester Deep River Essex Homeschooled I give my child permission to walk home * yes no I give Tri-Town permission to use screen shots of my child for promotional purposes * Yes No Participant information (Providing the following information is optional; however, it affords the State of CT a clearer picture of who is served by Youth Service Bureaus throughout the state. Student names are not included in any data that is reported to the State of CT): Child’s identified race Select OneCaucasian African-American/Black Hispanic/Latinx Asian American Indian/Alaska Native Native Hawaiian/Pacific Islander Multiracial prefer not to answer Who this child lives with: Select One2 birth or adoptive parents 1 step & 1 birth parent 1 single mom 1 single dad grandparent(s) DCF foster parent(s) lives alone parents have joint custody other Is this child experiencing homelessness? Select Oneno yes lives in a shelter lives in someone else’s house lives in a hotel or motel lives on own and homeless other prefer not to answer Registration Fees You must select at least one item! $ 0.00 0 1 2 3 4 5 6 7 8 Registration Fees I accept the terms and conditions