Participant Registration Form

Summer 2019 Participant Registration Information

Please note the following: This is for YC PARTICIPANTS who have a physical disability.
DEADLINE: Forms are due on Monday, May 27.
ALL participants are required to complete a MEDICAL FORM for 2019 (if you completed one last season, you do not need to complete another one).
This is NOT your official schedule. Youth Challenge will send e-mail confirmation of the calendar once your selections have been reviewed AFTER the May 27th deadline.
PLEASE READ PROGRAM DESCRIPTIONS AND TRANSPORTATION OPTIONS CAREFULLY. Transportation options and restrictions are listed for each section and program.
SUGGESTED DONATIONS: YC suggests a donation of $20 per program (with transportation) and $10 per program (no transportation) during this season. Suggested donation amounts can be paid at your convenience. Again, this is a suggested donation and no participant will be denied programming for lack of monetary payment.
TRANSPORTATION: YC is able to provide transportation for many, but not all programs. If YC can provide transportation, the option is listed in a menu after the program selection section. Some programs may have a geographic priority for transportation. There is also 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, Program Manager, at mvecchio@youthchallengesports.com or (440) 892-1001 x 18.

PARTICIPANT INFORMATION

Participant last name: *
Participant first name: *
Participant date of birth: *
Participant age: *
Street address: *
City: *
Zip code: *
Primary contact name: *
Primary contact email: *
Primary contact phone number: *
Can receive text messages: *
YesNo
Participant's physical disability: *
Emergency contact name: *
Emergency contact phone number: *

DEMOGRAPHICS

Please note: Youth Challenge 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 which includes questions relating to household income, education, and race/ethnicity. This section is not required and information provided will not be shared.
Participant's gender: *
Participant's ethnicity: *
Parent education level: *
Family income: *

WEEKEND / SPECIAL EVENT PROGRAMS

Programs are listed in chronological order. Please read carefully for each program's transportation and age restriction information.
Car Wash Fundraiser
Saturday, June 15th. 10am - 2pm @ YC, Westlake. Open to ALL participants ages 8-18. Participants must be able to help wash, rinse and/or dry vehicles. Sign up for EITHER the morning or afternoon shift. Must provide OWN transportation.10am - 12pm12pm - 2pm
Overnight
Monday, July 1 - Tuesday, July 2 @ YC, Westlake. For ALL participants ages 12-18. Must provide OWN transportation to YC at 1pm on July 1st and be picked up the next day, July 2nd, at 10am.7/1 - 7/2
Summer's End Bash & Volunteer Celebration
Saturday, August 3. 6-9pm @ YC, Westlake. Open to ALL participants and their friends/families to help celebrate an awesome summer of YC fun and recognize our extra special teen volunteers! Must provide OWN transportation.8/3

YELP PROGRAMS

For participants ages 16-25.
YELP Peer Support
6-8pm @ Clague Park, Westlake. Participants must provide OWN transportation.Tuesday, 6/25Tuesday, 7/9
YELP Party in the Park
Wednesday, June 12th. 6-9pm @ Upper Edgewater Park, Cleveland. One way transportation TO program provided. Must provide OWN transportation home from Edgewater after program.6/12
YELP Party in the Park Transportation. CHECK ONE.
I will attend and can provide my own transportation to and from program.I would like to attend. Request YC transportation one-way TO program.
Transportation details: Please provide any specific information we may need when providing transportation.
Date *

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Participant Registration Form

Summer 2019 Participant Registration Information

PARTICIPANT INFORMATION

DEMOGRAPHICS

YC SUMMER: PART ONE (Weekly Programs)

MONDAY PROGRAMS

TUESDAY PROGRAMS

WEDNESDAY PROGRAMS

THURSDAY PROGRAMS

FRIDAY PROGRAMS

YC SUMMER: PART TWO (Camps)

WEEKEND / SPECIAL EVENT PROGRAMS

YELP PROGRAMS

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