2026-02-21 INSPIRE Youth Leadership Seminar registration

* Indicates required field

NOMINEE INFO

Student First Name *
Student Last Name *
High School Name *
Current Grade *
Student Email *
Student Phone
Food Restriction Requirements/Known Allergies
Emergency Contact Full Name *
Emergency Phone *
Relationship
Name and Likeness: *
Collins Freedom Foundation [CFF] regularly engages media and event photographers. As a program participant you will be visible on camera. By checking the box below, you are acknowledging you are aware of this and that photos of you may be shown on future marketing materials including but not limited to the CFF website, e-newsletter, print items, and social media posts.

NOMINATION INFO

Nominee's Current Leadership Positions
Nominee's Extracurricular Activities
What are you most interested in learning about at the INSPIRE Youth Leadership Seminar?
What is one thing you feel people should know about you?
Name of the person who nominated you. *
Email of the person who nominated you. *