Parents/Guardians

In order to take your teenager into our care, we will need to have a legal guardian fill out the form below. Your teenager will also have to fill out a form on the page titled “teens” to attend. If you are the parent please fill the form out below:

← Back

Thank you for your response. ✨

Legal Guardian 1 Name(required)

Guardian 1 Phone Number(required)

Legal Guardian 2 Name(required)

Guardian 2 Phone Number(required)

Other Guardian allowed to pick up teen(required)

Your Address(required)

Your Email(required)

Other Guardian or Emergency Contact Phone Number(required)

Teen you are filling the form out for (first and last name):

Teens Birthday

Teens Address

Teens Phone Number

Teens allergies, sensory needs, triggers, or sensitivities:

Does your teen have any fears or situations they would struggle in?

What do you hope your teen will get out of coming to the teen center?

Is there anything that we need to know about your teenager?

Have you looked through the rules and regulations?

Yes No

Do you approve your teen to be on video and posted on social media for The Hangout?

Yes No Ask First

Do you approve your teen to be in pictures and posted on social media for the Hangout?

Yes No Ask First

Do you give permission for your teen to leave the teen center without you bring present?

Yes No

If your teenager repeatedly breaks rules and refuses to correct behavior after the staff has confronted them, do you understand it is your responsibility to pick your teenager up? Repeated rule breaking without correction will result in a ban from the center for a designated period of time.

Yes No

SubmitSubmitting form

Δ