Registration Form

Youth Registration Form

CITC's Unsah Jan Prevention Wellness Activities
Unsah Jan meaning for First Day is Cook Inlet tribal Council’s tobacco, substance use, and suicide prevention program for youth age 10-17 and young adults age 18-24.

Unsah Jan strives to support individual well-being through training and healthy activities. Give us a call at 907-793-3224 to get connected and let today be your First Day of being well!
Children's Names

Child 1: First Name Only Child 2: First Name Only Child 3: First Name Only
Parent/ Guardian Name

First Name Last Name
Parent/ Guardian E-mail
example@example.com
Parent/ Guardian Mobile Number
Emergency Contact
Emergency Contact Number
Comments/ Allergies/ Special Needs
Should be Empty:

Youth Registration Form