Participant Registration Form

SUMMER 2020 PARTICIPANT REGISTRATION INFORMATION

Please read below carefully: This is for YC PARTICIPANTS who have a physical disability.
DEADLINE: Forms are due on Friday, June 12.
ALL participants are required to complete a LIABILITY RELEASE form that will be sent via email.
ALL participants are required to complete a MEDICAL FORM for 2020.
This is NOT your official schedule. Youth Challenge will send e-mail confirmation of the calendar once your selections have been reviewed AFTER the June 12th deadline.
BEFORE registering for programs, be sure to read the YC Summer 2020 Safety Protocol document thoroughly. This document was emailed to you and you may also find it on our website.
Please read this form carefully because this summer, things will look A LOT different at YC. However, since we are all about adapting, we have created a safe plan to try to see as many of you as possible.
Program options: Virtual programs, in-person programs, and Metroparks Meet-Ups (see specific section on form for details).
SUGGESTED DONATIONS: YC suggests a donation of $10 per program 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: This summer, YC is encouraging participants to provide their own transportation, if possible. For those who are unable to provide own transportation, YC is able to provide transportation for the in-person program sessions. 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, 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 *
For in-person programs, is the participant able to/comfortable with wearing a mask when needed (i.e. restroom)? *
Emergency contact name (other than contact listed above) *
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: *

METROPARKS MEET-UPS

Description:
For participants of all ages. Priority given to Krazy Kamp participants. These will be very small, casual meet-ups in various MetroPark locations throughout Northeast Ohio. We will gather socially to hike, walk, talk, etc. Must provide OWN transportation. Locations TBD. Meet-ups time frame: 3-4pm.
Please check the box if you are interested in this.Yes, I am interested.

YELP Programs

YELP Peer Support
For participants ages 16-25. These programs will be hosted virtually via Zoom. A computer or phone with internet access is required. Program's are on Wednesday's from 6-7pm.June 17June 24July 1July 8July 15July 22July 29August 5

PEN-PAL PARTNER

Description:
You'll be assigned a partner from a (very) safe social distance and be given their contact info to send notes, cards, letters and emails throughout the summer. Please check below if interested.Yes, I am interested.

RACE DAY

Description:
Race Day is going virtual this year! Please check below if you're interested in performing a 5k or 1 mile fun run alongside YC staff and volunteers. Date, location, and time TBD.Yes, I am interested.

RELEASE OF LIABILITY

Release of liability will be sent to you in separate email to complete and return PRIOR to attending programs.
Please date this form *

Verification

Please enter any two digits *Example: 12
This box is for spam protection - please leave it blank:

SUMMER 2020 PARTICIPANT REGISTRATION INFORMATION

PARTICIPANT INFORMATION

DEMOGRAPHICS

PROGRAM SIGN-UP

VIRTUAL PROGRAMS

IN-PERSON PROGRAMS

METROPARKS MEET-UPS

YELP Programs

PEN-PAL PARTNER

RACE DAY

RELEASE OF LIABILITY

Verification