Virtual Youth Meeting Registration

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During this time it is important to provide support for our community. Young people especially need our support now more than ever! While we cannot meet in person, Sow A Seed Community Foundation remains opened virtually, online, and via phone to provide Mentoring and Healthy and supportive activities for our youth. Use this registration form to register your youth for one of our upcoming Zoom Youth Group meetings or activity.
The youth must be registered to receive the Zoom meeting information.

Call our office or visit our website, if you need additional information. (209)229-4559 www.sowaseedcf.org

Email *

Participants First Name *

Participants Last Name *

Has the Participant ever attended a Sow A Seed program? (check all that apply) *

Anger Management

Boys to Men Conference

Boys Council

Fresh Start Thinking

Girls Circle

Mentoring

One-on-One Counseling / Family Thearpy

Summer Camp

Y.L.I.A ( Young Leaders in Action)

Other:

Required

Participant's Age (ages 9 -18 only) *

Participant's Birth date (type in correct year) *

YYYY

Participant's School Name and Location *

My child would like to attend the Zoom Meeting/ Activity checked below. (check all that apply) *

Anger Management Group Meeting - date & time TBD

Boys Council ( boys group meeting ages 9 - 13) - Wed. 11am - 12:00pm

Fresh Start Thinking ( Co-Ed group meeting ages 14-18) - Mon. 11am - 12:00pm

Girls Circle ( girls group meeting ages 9-13) - Mon. 12:30pm -1:30pm

Mentoring - by appointment

One-on-One Counseling / Family Thearpy - by appointment

Y.L.I.A ( Young Leaders in Action, high school youth leadership group ) - Wed 6pm - 7pm

Other:

Required

Referred by *

Parent

School

Child Protective Services (CPS)

County Agency

Other:

Home Street Address *

City *

If "Other" City, please list here

Zipcode *

Contact Phone Number (ie. xxx-xxx-xxxx) *

Other Phone Number (ie. xxx-xxx-xxxx)

I give permission for the youth listed above to participate in the Sow A Seed virtual meeting designated above. *

Yes, I give permission. I am the parent of the participant listed above

Yes, I give permission. I am the guardian of the participant listed above

I am 18 years of age, and will participate in the Group Meeting designate above

Required

Parent/ Guardian Name ( First, Last) *

Parent / Guardian email address (cannot be a school-based email address)

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