Saturday, February 20th, 2010
Merion Mercy (Host) with St. Joe’s Prep and Devon Prep
Saturday, February 20, 2010
Registration: 8:30-9:00am
Event: 9:00am-2:00pm

511 Montgomery Avenue
Merion, PA  19066-1214
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You are invited to join the students and faculty of  Merion Mercy, St. Joe’s Prep and Devon Prep to discuss important issues in society that can affect youth, educators, and parents. You will be participating in two breakout sessions on the topics listed below. We ask students and parents to fill out the registration forms below and submit by Wednesday, February 17th. Only one person can be registered on this form but the form may be filled out as many times as needed.

Click here for details on breakout session topics.

Online registration is now closed. Please register at Merion Mercy. Thank You!

• Title: Ms. Mrs. Mr.        • You are a : Youth Educator Parent / Guardian

• First Name:

• Last Name:

• Gender : Male Female            • Grade:(if a student)

• Phone:    • School Association:


• Address:


• City:     • State:   • Zip:


• Email:

• To assist us in identifying family members when assigning you to your preferred workshop please list the names of other family members attending:
(Separate Registrations are needed for each individual listed below).

Please note, family members will not be placed in the same breakout rooms.



• Rank your choices in order of preference:

First choice:
Drugs & Alcohol
Sex and Pressure
You Don’t Know Me
Self Worth
Internet and Media

Second choice:
Drugs & Alcohol
Sex and Pressure
You Don’t Know Me
Self Worth
Internet and Media 		Third choice:
Drugs & Alcohol
Sex and Pressure
You Don’t Know Me
Self Worth
Internet and Media



If you do not give us your permission to use your image in video or photography, please check here.





Please note that all participants will be attending 2 breakout sessions. Youth and parents from the same family will not be placed in the same breakout session.

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