Participant Registration Form 2

FALL 2023 PARTICIPANT REGISTRATION

Please note the following:

This is for YC PARTICIPANTS who have a physical disability.

DEADLINE: Forms are due on AUGUST 29.

ALL participants are required to have a medical form on file prior to attending programs. If you already completed one and there are no changes, you do NOT need to complete another one.

***If your address, phone number, or emergency contact has changed, please be sure to let Mackenzie know. ***

This is NOT your official schedule. Youth Challenge will send e-mail confirmation of the calendar once your selections have been reviewed AFTER the deadline.

TRANSPORTATION: YC is able to provide transportation for most programs. There is an option to provide detailed transportation information (such as alternative address or specific instruction for staff/drivers).

**Please complete the ENTIRE registration form and click “submit” at the end. For REGISTRATION QUESTIONS, contact:
Mackenzie Vecchio, Director of Program Services, at [email protected] or (440) 892-1001 x 18.

PARTICIPANT INFORMATION

Participant last name: *

Participant first name: *

Participant age: *

Primary contact name: *

Primary contact CELL phone number: *

Primary contact email: *

Has anything changed from your most recent YC medical form submission? *

Yes

SCHOOL INFORMATION

Please provide ALL school information below to help us with routing for programs.

School name:

School street address:

School city:

Earliest time child can be picked up from school:

Latest time child can be picked up from school:

Time child arrives home from school:

DEMOGRAPHICS

This section is not required and information provided will not be shared. Information will not impact the participant's eligibility for programming. YC receives substantial funding from Foundations and Community Partners. Often, they require certain demographic and income data to ensure that their grantees meet requirement set forth in specific funding guidelines. If you are comfortable doing so, please complete the following section.

PROGRAM SIGN-UP

Programs are listed chronologically by weekday. Please pay close attention to location and age restrictions. Check the programs you wish to attend. Then, check your transportation preferences and add any transportation details you wish to share.

MONDAY - EAST

BOWLING

11/13

11/27

12/4

12/11

For east side participants ages 6-18. Program time 4-5:30pm @ Wickliffe Lanes. Round-trip transportation provided.

TUESDAY - ALL

GOLF & FRISBEE

9/12 - Disc Golf

9/19 - Ultimate Frisbee

9/26 - Goofy Golf

For all participants ages 6-18. Program time 4-5:30pm @ Cahoon Creek Disc Golf and Huntington Reservation, Bay Village. Round-trip transportation is provided.

ADAPTED ART & ACTIVITIES

10/3

10/10

10/17

10/24

For all participants ages 6-18. Program time is 4-5:30pm at Emerald Necklace Marina, Rocky River. Round-trip transportation is provided.

DANCE & DRAMA

11/7

11/14

11/28

12/5

12/12 - Cast Party

12/16 - Holiday Show at Near West Theatre (must provide own transportation)

Open to all participants, ages 6-18. Program time is 4-6pm @ YC, Westlake. Our participants and volunteers will produce, write, direct, and choreograph a one-of-a-kind holiday film for all to enjoy on December 16th at Near West Theatre. Round-trip transportation provided.

WEDNESDAY - WEST & LC

FOOTBALL

9/13

9/20

9/27

10/4

**Saturday, 10/7 (must provide own transportation); 10-12:30pm @ YC

Open to west and Lorain County participants ages 6-18. Program time 4-5:30pm @ YC. **Must be able to attend the Superbowl Showdown on Saturday, October 7. Round-trip transportation provided.

ARCHERY & FISHING

10/11

10/18

10/25

For west & LC participants ages 6-18. Program time 4-5:30pm at South Central Park, N. Ridgeville. Round-trip transportation is provided.

BOCCIA or CERAMICS

Check here for BOCCIA

Check here for CERAMICS

11/1

11/8

11/15

11/29

12/6

12/13

For west or LC participants ages 6-18. Program time 4-5:30pm @ YC. Select either boccia OR ceramics (cannot do both). Round-trip transportation is provided.

THURSDAY - EAST

FOOTBALL

9/14

9/21

9/28

10/5

**Saturday, 10/7; 10-12:30pm @ YC

Open to east side participants ages 6-18. Program time 4-5:30pm @ Hanna Perkins, Shaker Hts. **Must be able to attend the Superbowl Showdown on Saturday, October 7. Round-trip transportation provided.

SPOOKY SPORTS

10/12

10/19

10/26

Open to east side participants ages 6-18. Program time 4-5:30pm @ Highland Heights Community Park. Round-trip transportation provided.

ART & GAMES

11/9

11/6

Open to east side participants ages 6-18. Program time 4-5:30pm @ Urban Community School, Cleveland. Round-trip transportation is provided.

CREATE & COMPETE

11/30

12/7

12/14

Open to east side participants ages 6-18. Program time 4-5:30pm @ Hanna Perkins, Shaker Hts. Round-trip transportation is provided.

FRIDAY - WEST & LC

FESTIVE CREATIONS

11/3 @ Avon Library

11/10 @ Elyria Arts Council

12/1 @ Avon Library

12/8 @ Elyria Arts Council

Open to west and LC participants ages 6-18. Program time 4-5:30pm @ Avon Library and Elyria Arts Council. Round-trip transportation is provided.

FRIDAY - ALL

HALLOWEEN PARTY

10/27

Open to all participants ages 6-18. Program time 4-7pm @ YC. One-way transportation TO program is provided.

TEAM SPORTS

SOCCER - WEST & LC

9/8

9/15

9/22

9/29

10/6

10/13

**Saturday, 10/21 game vs Empower Sports; 10-12pm

Open to ambulatory west and Lorain County participants ages 10-21. Program time 5-6:30pm @ Schwartz Rd Park, Avon. Highly encouraged to be able to attend the Soccer Showdown on Saturday, October 21 @ St. Mary's Berea. YC may provide transportation on a limited basis.

SOCCER - EAST

9/8

9/15

9/22

9/29

10/13

**Saturday, 10/21 game vs Empower Sports; 10-12pm

Open to ambulatory east participants ages 10-21. Program time 4:30-6pm @ Forest Hill Park, Cle Hts. Highly encouraged to be able to attend the Soccer Showdown on Saturday, October 21 @ St. Mary's Berea.

MINI CAMP

MINI CAMP SIGN-UP

FALL FUN on Saturday, 9/9 at Preston's H.O.P.E., Beachwood. Program time 11-2pm.

FRIENDSGIVING on Saturday, 11/11 at YC, Westlake. Program time 11-2pm.

For all participants ages 4-10. Round-trip transportation is provided.

TRANSPORTATION PREFERENCES

TRANSPORTATION OPTIONS, CHECK ONE:

Would like YC to provide round-trip transportation.

Will provide own transportation.

Would like YC to provide one-way transportation TO program from home/school/other.

Would like YC to provide one-way transportation HOME AFTER program.

Transportation details: Please provide any specific information we may need when providing transportation.

YELP PROGRAMS

For participants ages 18-25. YC may provide transportation on a limited basis. Please see below for program specifics.

YELP CAMPING PREP

9/12

9/19

For participants attending the annual YELP Camping Overnight on September 30-October 1st. Camping Prep is 6-7:30pm @ YC. **Must be able to attend the Camping Overnight.

YELP CAMPING OVERNIGHT

9/30-10/1

A full 24 hours of YC fun in nature. Partnering with the Cleveland Metroparks, this program will take place at Look About Lodge in South Chagrin Reservation. Program will include hiking, scavenger hunt, fire building, camp cooking, games around a fire, and sleeping overnight in tents. Participants must meet at YC at 11am on Saturday, September 30 and be picked up from YC on Sunday, October 1 at 11am. This program is unique and a fan favorite at YC! Contact Mackenzie with any questions.

YELP & ACT FRIENDSGIVING

11/14

Program time 6-7:30pm at YC.

YELP & ACT IMPROV

11/30

12/7

Learn and try out some Improv acting and comedy. Program time 6-7:30pm at YC.

YELP TRANSPORTATION PREFERENCES

YELP TRANSPORTATION OPTIONS, CHOOSE ONE:

I will provide my own transportation.

Request YC transportation if available.

reCAPTCHA is required.