Registration Form

Gender Diverse Adolescents & Their Guardians

Participation(Required)
Who will be participating?
Please list your child's affirming name and pronouns (e.g. she/they). If your child is NOT participating, write "N/A"
If multiple parents wish to participate, please write both their names here. Please also share your pronouns.
Consent to Email(Required)
If you were referred by a provider or community member, please list their name/organization here.
Consent