Good Journey Development Foundation 2023 Program Application
Good Journey programs begin in January 2023. Complete and submit this application asap to be included!

Good Journey Programs to choose from are:

1 - Summer Leadership Academy - June 5 through July 21

2 - Bustani Ya Upenda (Garden of Love) - Saturdays & Tuesdays, March through October

3 - Second Look Podcast - Wednesdays & Saturdays, January through December

4 - Community Involvement & Cultural Exchange, Saturdays, January through December

5 - Xpress U Thru Art, Afterschool, Saturdays, Summer (location dependent)

*SEE BELOW FOR PROGRAM DESCRIPTIONS*

Contact Dionne at 314-229-9079 or dionne.ferguson@goodjourney.org for more information.
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Summer Leadership Academy
Good Journey's seven weeks of SUMMER LEADERSHIP ACADEMY at F.I.R.E., and Bustani Ya Upenda (Garden of Love) JUNE 5 - JULY 21, MONDAY-FRIDAY, from 9AM to 5:30PM. The 2023 Theme is So St. Louis! Over the summer young people will experience painting, dancing, poetry, STEM, martial arts, book club, KiSwahili, outdoor games, Black History, gardening and community service, and weekly fieldtrips.  AGES 9 TO 16 WELCOME TO APPLY. Total cost is $225 per youth for the summer. Scholarships are available. Breakfast, Lunch and Snack provided daily. Complete the application below and select SUMMER LEADERSHIP ACADEMY.
Bustani Ya Upenda (Garden of Love)
Good Journey's youth community garden, BUSTANI YA UPENDA (Garden of Love) is where young people of ALL AGES work with families, adult mentors and community members to grow and harvest produce for themselves, families and the community, while learning healthy farming and food lessons. Youth and Elder growers meet SATURDAYS, 10AM-12PM, and TUESDAYS, after 4PM in the garden. Complete the application below and select BUSTANI YA UPENDA.
A Second Look Podcast
Good Journey's SECOND LOOK PODCAST is created, led and produced by TEENAGERS who focus on topics and guests of interest to them, their peers and community.  They meet virtually on Wednesdays and in person on Saturdays. Complete the application below and select SECOND LOOK PODCAST.
Community Involvement & Cultural Exchange
Good Journey's COMMUNITY INVOLVEMENT & CULTURAL EXCHANGE is a youth global citizen and ally building project for AGES 13 to 18. Young people meet on Saturdays, 2 to 3 times a month, to prepare for their cultural exchange and plan for community change work. Complete the application below and select COMMUNITY INVOLVEMENT & CULTURAL EXCHANGE.
Xpress U Thru Art
Good Journey's XPRESS U THRU ART is a healing arts program facilitated by artists and counselors for young people in similar age groups ranging from ages 8 to 25. Xpress U Thru Art operates in partnership with schools and community organizations. Xpress U Thru Art session meeting days and times are determined by community partners and facilitators. Complete the application below and select XPRESS U THRU ART.
GOOD JOURNEY PROGRAM APPLICATION
Good Journey Development Foundation has planned programs of cultural, social and educational learning experiences in collaboration with community organizations and community leaders. Through the programs, your child(ren) will be matched with leaders, mentors, educators, artists and volunteers who will meet and work with them. Activities will, customarily, be held at the F.I.R.E. location at 1020 N. Taylor, St. Louis, MO 63113, the Bustani Ya Upenda location at 5059 Vernon Avenue, St. Louis, MO 63113, virtually and other locations in the St. Louis Region. We want your consent, as set out below, to involve your child as a part of Good Journey Development Foundation's programs and activities. By filling out and submitting this Parental Consent Form to Good Journey Development Foundation, you, the legal parent/guardian give your consent for your child(ren) to participate in all Good Journey Development Foundation programs and activities.
I am age 18 or older and applying to participate in the following Good Journey program(s):
OR 
My child(ren) are under age 18 and I am applying for my child(ren) to participate in the following Good Journey program(s):
 *
Required
PLEASE TYPE IN YOUR NAME BELOW AS THE LEGAL PARENT/GUARDIAN PROVIDING CONSENT AS SET OUT ABOVE AND BELOW TO INVOLVE YOUR CHILD(REN) AS A PART OF ALL GOOD JOURNEY DEVELOPMENT FOUNDATION'S PROGRAMS AND ACTIVITIES AND LOCATIONS (IF 18 OR OLDER, PLEASE TYPE IN YOUR NAME): *
LOCATION OF ACTIVITIES:
F.I.R.E., Bustani Ya Upenda, Beckett Park, Neighborhoods (Academy-Sherman Park, Lewis Place, Vandeventer, Fountain Park), Turner Park, O'Fallon Park YMCA, Wohl Recreation Center, Progressive Emporium & Education Center,  Missouri State Parks, Exodus Gallery, Deaconess Foundation, and other program and fieldtrip locations with details provided to parents/guardians and youth.
TRANSPORTATION:
Transportation is provided or approved by parents or guardians. Fieldtrip transportation is provided by Good Journey Development Foundation and its affiliated staff, volunteers and organizations.
PLEASE COMPLETE THE FOLLOWING INFORMATION REQUESTED BELOW:
Youth's full name: *
Youth's age: *
1st Youth address - include zip code: *
1st Youth cell number:
2nd Youth's full name:
2nd Youth's age:
Clear selection
2nd Youth address - include zip code:
2nd Youth cell number:
3rd Youth's full name:
3rd Youth's age:
Clear selection
3rd Youth address - include zip code:
3rd Youth cell number:
4th Youth's full name:
4th Youth's age:
Clear selection
4th Youth address - include zip code:
4th Youth cell number:
Parent/Guardian address - include zip code:
(If age 18 or older include Emergency contact information name and address)
 *
Parent/Guardian home number:
(If age 18 or older include Emergency contact home number)
 *
Parent/Guardian cell number:
(If age 18 or older include Emergency contact cell number)
 *
Parent/Guardian work number:
(If age 18 or older include Emergency contact work number)
Parent/Guardian email address:
(If age 18 or older include Emergency contact email address)
2nd Parent/Guardian name:
2nd Parent/Guardian address - include zip code:
2nd Parent/Guardian home number:
2nd Parent/Guardian cell number:
2nd Parent/Guardian work number:
2nd Parent/Guardian email address:
1. I understand that I, as a Good Journey program participant am responsible for my travel, or as the parent/guardian of a Good Journey participant I am responsible for my child(ren)'s travel to and from the program location, unless the program is transporting Good Journey program participants in connection with fieldtrips, or a specific arrangement has been communicated by me to Good Journey Program Directors.
2. As a Good Journey program participant Good Journey has my permission, or as a parent/guardian of a Good Journey program participant, my child(ren) has my permission to be transported in the manner described above.
3. As a Good Journey program participant I understand that I, or as the parent/guardian of a Good Journey program participant I understand that my child(ren), will be under supervision by personnel working under the auspices of Good Journey Development Foundation and I agree, or instruct my child(ren) to obey all rules, regulations and instructions given by staff, volunteers and/or mentors authorized by Good Journey. I further agree that no authorized personnel shall be held liable for any harm incurred by me as a participant, or my child(ren) as a result of my child(ren)'s deliberate, disobedience of rules, regulations or instructions.
4. The authorized personnel, volunteers and mentors under the auspices of Good Journey will supervise all participants, and neither they, nor Good Journey, nor any collaborating organization shall be liable, absent gross negligence on their part.
YOUR SIGNATURE AND DATE (TYPE NAME AND THE DATE) BELOW INDICATES THAT YOU HAVE READ AND AGREED TO THE AFORESAID AND THAT WE HAVE YOUR PERMISSION FOR YOU AS A PARTICIPANT, OR YOUR CHILD(REN) TO PARTICIPATE IN THE ACTIVITIES AND TO HAVE TRANSPORTATION PROVIDED AS REQUIRED BY ACTIVITIES (Type name & date to sign below): *
MEDIA RELEASE: I consent to myself or my child(ren) as participants to be interviewed, photographed, videotaped by authorized parties or designees of Good Journey Development Foundation. I also consent to my participation or my child(ren)'s participation in activities of Good Journey, under the auspices of Good Journey Development Foundation and to have any of the photographs (digital/paper), slides, computer images, videos, slide shows, and/or audio-television interviews used for public relations, news articles, advertising, research and or inclusion on Good Journey affiliated social medial and official websites. As participants and/or as parents/guardians, I waive all rights I may have to any claims for payments or royalties in connection with any of the publicity. I also waive all rights to inspect or approve any photo, video, film, interview as it relates to Good Journey Development Foundation when and if I and/or my child is a participant. I further consent to have all negatives and positives, whether prints, video film or sound recordings released to Good Journey Development Foundation, Inc. and recognize that all said materials are the property of Good Journey Development Foundation. *
I declare that I am legally eighteen (18) years or older and legally competent to execute the above media release. I consent to abide by these terms and I have voluntarily signed this document. I consent to hold harmless and release and forever discharge Good Journey Development Foundation from any claims, demands and causes of action which I, my heirs, representatives, executors, administrators or any other persons acting on my behalf of my estate. I hereby certify that by signing this document, I do herby give my consent without reservation to the Media Release for myself or my child(ren) to be included in media and publicity efforts of Good Journey Development Foundation. My signature (TYPED NAME AND DATE BELOW) on this Media Release authorizes my willing consent hereby:
A copy of your responses will be emailed to the address you provided.
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