Youth Empowering Youth: Free Online Leadership Program, Ages 13-18

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Days: Sundays
Time: 1:00 - 2:30PM Pacific Time

Session 1: Sunday July 25 2021 - The Ripple Effect
Session 2: Sunday August 1 2021 - Attitude Creates Your Life
Session 3: Sunday August 8 2021 - The Moment You Stop Blaming, You Take Back Your Power
Session 4: Sunday August 15 2021 - Take Action! With Small Steps
Session 5: Sunday August 22 2021 - Fail Forward to Success
Session 6: Sunday August 29 2021 - Drive Your Life with Powerful Habits
Session 7: Sunday September 5 2021 - Be A Student of Life
Session 8: Sunday September 12 2021 - Momentum is Your Responsibility
Session 9: Sunday September 19 2021 - Graduation & Next Steps

Please note that this online program will be recorded for: (1) Internal Use - training and quality assurance; (2) Participant access - for participants who want to review or who miss a class, this feature is only available during the program and recordings are not downloadable; (3) If parent indicates media consent in registration form below, clips may be used for program promotion/testimonials.

Questions?
Contact Mia Takeuchi, YEY Program Coordinator:
mia@lowentropy.org

Website: https://lowentropy.org/youth-empowering-youth/

I commit my youth to attend the full 9-session online program: *

Sundays, 1:00 - 2:30PM Pacific Time, starting July 25, 2021

Youth Full Name (First and Last Name) *

Youth Preferred Gender Pronouns *

E.g.) She/Her, He/His, They/Their etc.

Youth Age *

Youth Date of Birth *

YYYY

Youth Grade *

City You Live In *

Parent/Guardian Full Name (First and Last Name) *

Parent/Guardian Relationship to Youth *

Parent/Guardian Phone Number *

Parent/Guardian Email *

Youth Email *

Do you want emails delivered to Parent/Guardian, Youth, or both? *

ONLY Parent/Gaurdian

ONLY Youth

BOTH Parent/Guardian AND Youth

What school does the youth attend? *

Any additional information you would like us to know about your youth? (Optional)

How did you hear about this program? *

If you chose "Other" for the previous question, please elaborate:

Media Consent: photos and audio/video recordings may be used to publicize or promote the Youth Empowering Youth Program. I give consent for photos and audio/video recordings of my youth to be taken and used to publicize the work of Youth Empowering Youth. *

Yes

Required

Media Consent: first names of youth may be used to publicize or promote the Youth Empowering Youth Program. I give consent for my youth's first name to be used to publicize the work of Youth Empowering Youth. *

Yes

Required

Terms and Conditions: These terms and conditions are to be followed by all participants of the Youth Empowering Youth Online Program including parents and children/minors. A parent or guardian over the age of 18 must agree to these terms on behalf of the child (children/youth) participating in the Youth Empowering Youth Zoom platform. The following behavior and protocol must be followed in order to participate in Youth Empowering Youth Program on Zoom. I understand that: *

Each participant must turn on their video camera in order to participate in the program for safety and security reasons.

Two trained Youth Empowering Youth Facilitators will be present during each 90min Live program.

Facilitators will be checking to ensure that only youth between 13-18 years are participating in the program. Video cameras displaying ONLY an adult, photo or otherwise hidden figure will be removed from the program as a safety measure to protect the students in the Youth Empowering Youth Program.

No bullying, coarse language (swearing), or any behavior considered unacceptable, such as but not limited to nudity, vulgar gestures, discriminatory language (racism, bigotry, sexism) will be tolerated. Students found displaying this behavior will be immediately removed from the program and further discussion with their parents will need to be had before they can be readmitted into further programming.

Required

Parents/Guardians: By typing your name below, you agree to the above conditions and give permission for your youth to participate in this program. *

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