REIMAGINE: I AM THE CHANGE               Barbershop Talk Series 
Please complete the form below to register for the Barbershop Talk Series Around Mental Health & Wellness for fathers, men, sons, boys, and young men of color. 
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Full Name *
Phone Number *
Email Address  *
Zip Code *
How do you describe your race/ethnicity? *
Age? *
Session Dates - Please check all dates that you'd like to attend (you can select more than one) 
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What are some topics you would like to have discussion around or learn about?
Any food allergies? If so, what are you allegirc to? *
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