Enroll — ThinkRoot Young Leaders

About your child

Child's full name *

Date of birth *

Age

Grade *

Parent / guardian information

Parent / guardian name *

Phone *

Email *

Emergency contact name + phone *

What made you interested in ThinkRoot Young Leaders for your child? *

Is there anything specific you hope your child will gain from the program?

Program agreement

ThinkRoot Young Leaders is an educational program focused on mindset skills, emotional intelligence, and mind-body science. It is not therapy, counseling, or a mental health intervention, and is not a substitute for professional mental health support.

I give permission for my child to participate in all program activities including breathwork, journaling, movement exercises, and group discussion.

I understand that personal reflections shared by my child are kept confidential within the group.

I have read and agree to all of the above. *

Testimonial permission *

May your child's first name and general feedback be used in anonymized program testimonials?

Yes, I give permission No, I do not give permission

Parent / guardian name (print) *

Date *

Questions before enrolling? WhatsApp or call us at (510) 509.5072

You will receive a confirmation once our team reviews your form.
ThinkRoot Young Leaders — Where great minds take root.

This program is educational in nature and is not a substitute for professional mental health support.

Reserve your child's spot