Youth Impact Program Application

Youth Impact Program Application

Apply to participate in the Rooted Juneteenth Cultural Experience Youth Impact Program. Open to applicants ages 16–24 seeking mentorship, exposure, and creative opportunities.
Full Name

First NameLast Name
Age (16–24)
City
State
Creative category

Other
This Is What Rooted Looks Like

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Please upload a video introducing yourself to the world as an applicant looking for support and mentorship on the journey ahead. (Video file required. Accepted formats: MP4, MOV, AVI, etc.)
Parent/Guardian Verification (for applicants under 18)
Upload a picture of your parent/guardian holding their ID with today’s date (2026-05-21) visible.

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Parent/Guardian Signature (Permission for participation)

Youth Impact Program Registration

Covers integration into the show, mentorship, and participation in the Rooted Juneteenth Cultural Experience Youth Impact Program.

$75.00

Total

Credit Card

Apple Pay

Google Pay