Messages from Past and Future

Messages from the Past

Parents Name*

List below messages that you were given as a young person that either through acceptance or resistance have guided your self-image “You can do anything” “You don’t work up to your potential.”*

Messages for the Future

List below a message that you are giving your young person about who they are:”*

Group leaders email address*
This is where your form will be sent, please check spelling

Your email address
This is optional, please fill out if you wish to recieve a copy for your records.