OUT Maine · EVENT-20231005-CCPH

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EVENT-20231005-CCPH

LGBTQ+ Parents' Night & Youth Social

Gorham, Maine

Thursday, October 5th, 2023, 5:30 pm - 6:30 pm

This social gathering is for parents/guardians to connect with and enjoy the company of others, while providing their LGBTQ+ youth, aged 9 - 18, with a safe and affirming place to connect with and support other queer youth.

Hosted by Cumberland County Public Health and OUT Maine.

The event location will be provided in a separate email once your registration has been received.

Light snacks will be provided.

Attendee Information

Parent/Guardian Name

First Name

Last Name

Pronouns

Please check all that apply.

he/him/his

she/her/hers

they/them/theirs

other

Gender

(For demographic reporting purposes only)

Female

Male

Transgender

Gender-Neutral

Non-Binary

Agender

Pangender

Genderqueer

Two-Spirit

Third Gender

Other

Prefer not to answer

Race

(For demographic reporting purposes only)

White/Caucasian

Black or African American

American Indian or Alaska Native

Asian

Native Hawaiian or Pacific Islander

Prefer not to answer

Ethnicity

(For demographic reporting purposes only)

Hispanic or Latinx

Not Hispanic or Latinx

Prefer not to answer

Verify Email

Phone

Second Parent/Guardian Name, if applicable

First Name

Last Name

Second Parent/Guardian Pronouns

Please check all that apply.

he/him/his

she/her/hers

they/them/theirs

other

Address Type

Address

Address Line 1

Address Line 2

City

State

State/Province

ZIP/Postal Code

What county do you live in?

How many children are coming with you? If none, enter "0."

(Please note, this event is suitable for children aged 9 - 18.)

Please list the preferred names of the children attending (enter N/A if none):

Grade level of children attending (if applicable)

(Please check all that apply)

N/A

3rd

4th

5th

6th

7th

8th

9th

10th

11th

12th

Does anyone in your party have any dietary restrictions? If none, write "none."

Notifications

(Optional)

I would like to receive updates about the following:

Youth programs

Training opportunities

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