Privacy Policy

This statement describes the policies and practices of the Young Men's Christian Association of Metropolitan Washington ("YMCA") regarding the collection and use of your personal information from your visit to our website and submission. The YMCA is a nonprofit organization whose principal mission is to foster the spiritual, mental and physical development of individuals, families and communities according to the ideals of inclusiveness, equality and mutual respect for all. The YMCA is committed to maintaining the privacy of visitors to our website and users of our Internet services. Please review our standards below.

Information Collected

General Use

The YMCA may collect and store information about you on an anonymous and aggregate basis. This information is used only to measure website traffic and activity so that we can continue to improve the site and provide the best services possible to our community. The YMCA is the sole owner of the information collected on this site. We will not sell, share, or rent this information to other businesses or individuals, and we do not track individual user's visits to our websites.

Security

The YMCA takes every precaution to protect our website users' information. When you use the YMCA's websites to register for events, purchase products or services, or join groups, the YMCA collects information necessary to process the transaction. This may include your name, address, telephone and fax numbers, e-mail addresses, vaccine status, and credit card or other payment information. This information is encrypted to insure that your private information is transmitted in a secure fashion. If we collect information for payment purposes, it is stored and used by us or by others we contract with to process orders for that transaction only. The YMCA makes no representations or guarantees regarding unlawful or inappropriate use of information entered in our websites by third parties.

Use of Information

The YMCA will sometimes use your e-mail address, address, fax number or other information to confirm a transaction, verify your identity, send you general information such as newsletters, or for similar purposes, either directly or through others we contract with. The YMCA will not disclose any information to third parties for any other purpose, and we will not sell mailing lists. In some cases, you will be given the choice not to have your information used for some of these purposes. In those cases, you will see information on how to make that choice.

Copyright

All text and graphic material displayed on this website is the exclusive, copyrighted property of the YMCA. Pass-along usage of any of our materials for any purpose other than the direct support of the YMCA is prohibited.

Contact

If you have any questions about this Privacy Policy, the privacy and security at our website, or our copyright restrictions, please contact the webmaster.





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YMCA DC YOUTH & GOVERNMENT 

LEGISLATIVE WEEKEND

March 29-30, 2024

FORMS AND REGISTRATION



Review YMCA of Metropolitan Washington Privacy Policy

YMCA OF METROPOLITAN WASHINGTON (“YMCA”) PARTICIPANT WAIVER FORM

ACKNOWLEDGEMENT

I expressly acknowledge that there are certain dangers, risks, illnesses and personal injuries inherent in participating in the YMCA’s programs, events, classes, and/or other activities, which may result from unavoidable accidents or injuries, athletic activities, sports programs/classes, the use of any equipment, exercise, or other activities or from my or my minor child(ren)’s or ward(s)’ physical condition. I understand that the YMCA and its employees, agents, counselors, teachers, trainers, representatives, successors and assigns assume no responsibility for loss, damage, illness or injury to person or property that I or my minor child(ren) or ward(s), if applicable, may sustain as a result of my or their physical condition or resulting from my or their participation in any activities, programs, events, classes, the use or non-use of any equipment, exercise, horseback riding, archery, field trips, waterfront and pool activities, canoeing/boating, campfires, hiking, high ropes and other challenge courses, or any other activities, classes, events, or programs at and/or sponsored by the YMCA. I expressly acknowledge, on behalf of myself and my minor child(ren) and ward(s), heirs and executors, that I voluntarily assume the sole risk for any and all dangers, illnesses and personal injuries that may result from my or my minor child(ren)’s or ward(s)’ participation in any events/activities/programs/classes while at the YMCA and/or sponsored by the YMCA.

I also acknowledge that the YMCA often uses photographs, videotapes, television programs, motion pictures, tape recordings, or other similar media for promotional purposes. I hereby consent to the use of my and/or my minor child(ren)’s or ward(s)’ name(s) and/or likeness(es) in such materials to be exhibited and used for advertising, trade purposes, solicitation of patronage, promotional purposes, or other similar purposes, even if my and/or my minor child(ren)’s or ward(s)’ name(s) and/or likeness(es) are an integral part of such photograph, videotape, television program, motion picture, tape recording, or other similar media.

RELEASE

In consideration of the YMCA allowing me and/or my minor child(ren) or ward(s) to attend and/or participate in any programs, events, classes, or other activities at the YMCA and/or sponsored by the YMCA, I hereby, for myself, my minor child(ren) or ward(s), heirs, and executors, waive, release and forever discharge the YMCA and its employees, agents, counselors, teachers, trainers, representatives, successors and assigns, from and against any and all rights and claims for any loss, damage, illness or injuries to person or property sustained as a result of my attendance and/or participation in any such programs, events, classes, and other activities, whether or not such loss, damage or injury results from the negligence of the YMCA and its employees, agents, or representatives or from some other cause. My agreement to release the YMCA does not include any loss, damage or injury that results from the YMCA's gross negligence or willful, wanton, or reckless misconduct.

I further waive any and all rights to inspect or approve the photograph, videotape, television program, motion picture, tape recording or other use of my and/or my minor child(ren)’s or ward(s)’ name(s) and/or likeness(es), including any written article, script, caption or other writing that may accompany such use of my and/or my minor child(ren)’s or ward(s)’ name(s) and/or likeness(es). I hereby, for myself, my minor child(ren) or ward(s), heirs, and executors, waive, release and forever discharge the YMCA and its employees, agents, counselors, teachers, trainers, representatives, successors and assigns, from and against any and all liability, claims, losses, costs, expenses or damages for libel, slander, invasion of privacy, conversion, defamation, appropriation of likeness or any other claim based on the use of my and/or my minor child(ren)’s or ward(s)’ name(s) and/or likeness(es) in any such materials.

INDEMNIFICATION

I hereby represent and warrant to the YMCA that I have the authority to execute this Participant Waiver Form on behalf of myself and/or on behalf of my minor child(ren) or ward(s) as parent, guardian and/or next friend, if applicable. In the event of any misrepresentation or breach of the foregoing warranty by me, or in the event that I, my minor child(ren) or ward(s), or any other person nevertheless asserts any claim against the YMCA arising out of my or my minor child(ren)’s or ward(s)’ participation in any program, event, class or other activity as set forth herein, I agree to indemnify, hold harmless and defend the YMCA from and against any and all liability, claims, losses, costs, expenses or damages resulting therefrom, including, but not limited to, claims of loss, damage, illness or injury to person or property whether or not such loss, damage, illness or injury results from the negligence of the YMCA or from some other cause.

ACCEPTANCE

I expressly acknowledge and agree to the terms and conditions set forth on this Participant Waiver Form. 

YMCA DC YOUTH & GOVERNMENT

PARTICIPANT AUTHORIZATION FORM

STUDENT EXPECTATIONS (Code of Conduct)

All participants in the YMCA Youth & Government program should demonstrate the positive values of Caring, Honesty, Respect and Responsibility. The types of personal behavior that are consistent with our purpose and objectives of the Youth & Government Program are listed here. The items within this "code” are based upon performance and are designed to protect the welfare of the program for future generations. Registration in this program indicates personal acceptance of these expectations. A signed copy will be required from each participant as a part of the registration process.

 

ASSUMPTIONS:

A. Delegation Advisors are responsible for the conduct and welfare of their student club delegate at all local and citywide functions. It is the responsibility of the advisor to help students live up to these expectations.

B. Every adult associated with the program is expected to perform as a Caring Adult Role Model. As such, they should take every opportunity to mentor to all Y&G members regardless of their actual club affiliation.

C. Key to consequences for violating the code of conduct:

(DOS) Discretion of Staff

(LP) Lose position – become observer

(CP-SH) Call parents – send home

(CS) Call Hotel or D.C. Government Security

(SP) Summon Police


THE CODE:

1.    Members are expected to remain on-site for all citywide functions unless the approval of their advisor AND the Director of the program is secured. Delegates who need to leave any citywide function early must give their advisor AND the Director of the Program a signed note from their parent or legal guardian. (CP-SH).

2.    Members are expected to be faithful stewards of the facilities, supplies, and equipment that we encounter. This includes the property of fellow delegates and staff, schools, the D.C. Government, and hotel. (Many furnishings in the D.C. Government buildings are of great historic value). (CP-SH), (CS) and possibly (SP).

3.    Members are expected to faithfully adhere to the rule prohibiting food and beverages in the Council Chambers, Committee or Caucus Rooms, offices, and other rooms. (LP).

4.    Members’ health and safety are very important to the YMCA and therefore we ask you respectfully refrain from the use of incense, tobacco products, and the use of or possession of alcoholic beverages or non-prescription drugs. Possession or use of a firearm or other instrument that could be used as a weapon is forbidden at any Y&G function. (CP-SH) and possibly (CS), and (SP).

5.    Male and female delegates may not visit each other’s hotel rooms, nor be on the same floor as the opposite gender. (CP-SH).

6.    Members are expected to strictly observe the established curfew when participating in overnight events. This means delegates must be in and remain in their assigned rooms with the doors closed until the curfew ends. (DOS) and possibly (LP).

7.    Members are expected to respect the sleep needs of others by eliminating all loud noises after scheduled curfew for overnight events. (CP-SH).

8.    Visitors to Y&G programs are always welcome. However, they are expected to be pre-registered and are restricted from observing the program. (DOS) and possibly (LP).

9.    At overnight events, members are expected to lodge in their assigned rooms unless switched with the approval of their advisor, and the Director is informed. (CP-SH).

10. Delegates are expected to attend ALL sessions of a program unless options are designated. (LP).

11. Members are expected to be identifiable by wearing their name badges at all times (including social activities) while attending Y&G events. (DOS) and possibly (LP).

12. Personal attire reflects upon personal attitude and the quality, purpose, and dignity of the entire Y&G Program. In the D.C. Government buildings, men are expected to wear a suit or sport coat with tie and trousers; women wear a dress, skirt and blouse, pants suit or dress pants with appropriate top. Shorts, jeans, and revealing attire are inappropriate in the D.C. Government. (DOS).

13. Members are expected to maintain the intellectual and productive level demanded by Y&G’s purpose and objectives. (DOS).

14. Members are expected to conduct themselves in an orderly and responsible manner, before, during and after all functions of the Y&G program. Personal behavior reflects upon the quality of the program, one's club, the YMCA, and oneself. (DOS).

15. All program participants are expected to accept and demonstrate the positive character values of caring, honesty, respect, and responsibility. (DOS)

To create and maintain a space that embodies our core values, the Y is serious about being clear regarding activities that are not allowed. If you violate this code of conduct, consequences can include termination of program privileges, being sent home (at the expense of the parent/guardian) and involving appropriate legal authority. The YMCA reserves the right to make situational decisions based on our policies, mission and values. 

All student participants, along with their parent/guardian, must submit their digital signature agreeing to this code of conduct prior to participating in all virtual YMCA programming.

 

VIRTUAL ETIQUETTE GUIDELINES:

 1.    Appropriate Video Call Etiquette

a. When registering/signing-in for any video call or meeting, please use your First & Last Name (not a random username), as well as your Delegation in parentheses. Example: George Williams (YMCA). This helps us to ensure the privacy of our meetings.

b.    Please find a quiet area and call-in at the scheduled time so you can be fully present. If you are able/willing to use the camera on your device, we encourage those participants to use their video function so we can see and hear you.

c.    Please do your best to keep background noise or distractions to a minimum. 

d.    Please do not take your phone or computer to the bathroom.

e.    Photos and videos of others without their expressed consent is prohibited.

2.    Appropriate Attire

Appropriate attire must be worn at all times. Clothing with vulgar language, obscene gestures, racial slurs, or anything that contributes to a hostile environment or would be considered inappropriate in a YMCA facility or program is not allowed. Appropriate tops and bottoms should be worn.

3.    Appropriate Language

Vulgar language, including swearing, name-calling or shouting/yelling at others is prohibited. When communicating in the chat box, please do not send links or information that is not aligned with our YMCA values.

4.    Creating a Welcoming Environment

Respect others’ cultures and personal way of being. We strive to create a safe emotional and physical space. We encourage participants to honor diversity in all dimensions and respect opinions or perspectives. The YMCA stands up against all forms of bullying, discrimination and racism.

5.    Appropriate Conduct

Any other conduct of an inappropriate, threatening or offensive nature will be investigated/evaluated by YMCA leadership. Teens that do not abide by this agreement may be prohibited from participating in future virtual events or in person activities.

6.    Alcohol, Tobacco and Drugs

The use of alcohol, tobacco, and drugs (including e-cigs/ tobacco-like products) is not permitted in or outside of ALL virtual calls. Participants that show, obtain, see in the background, make references to or use during the virtual calls will be removed from meeting and removed from future virtual and in-person events. Law enforcement may be involved if necessary.

Report an Issue

If a member, participant or guest feels uncomfortable in confronting someone directly about offensive behavior or other issues that are in violation of this code of conduct, we ask that you please report the behavior or issue to support@ymcadc.org to be addressed by YMCA staff.

To create and maintain a space that embodies our core values, the Y is serious about being clear regarding activities that are not allowed. If you violate this code of conduct, consequences can include termination of program privileges, being sent home (at the expense of the parent/guardian) and involving appropriate legal authority. The YMCA reserves the right to make situational decisions based on our policies, mission and values. 

All student participants, along with their parent/guardian, must submit their digital signature agreeing to this code of conduct prior to participating in all virtual YMCA programming.

I hereby authorize my child to participate in the YMCA DC Youth & Government. I understand that he/she will participate in a virtual program and adhere to the aforementioned general and virtual guidelines while under the supervision of their Youth & Government club advisor. 

If my child is an elected or appointed officer in this program they will need to attend training prior to the start of the event. I understand that staff and volunteers from the YMCA DC Youth & Government program will provide supervision that day.

Should my child require medical attention, I hereby authorize the YMCA DC Youth & Government program and/or their club advisor to secure qualified emergency medical care on the scene or at the nearest medical facility.

The YMCA DC Youth & Government program utilizes photographic images, in a variety of communication mediums. Your permission is requested to allow for the potential use of this delegate’s image in various print and multi-media formats. Images may be used to promote and provide education about the Youth & Government program, for grant writing and other fund-raising activities, advertising, or for any other purpose consistent with the Mission of YMCA DC Youth & Government. At no time or under any circumstance will the student's personal information be used or disclosed without additional and specific permission from the parent or guardian.

I have read and fully understand the attached Code of Conduct. Should my child be sent home for violation of the code, I am to pay costs associated with the return travel. I understand that I will be notified if such action is required and given the opportunity to select the means of transportation.








First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Registration

Name of school: *

Name of Adult Advisor / Chaperone *
Grade Level:*
This will be my _____ year in Youth and Government.*

Participant's Email Address *

Name of Emergency Contact *

Phone Number of Emergency Contact *

Email of Emergency Contact *

Please list any allergies, medical care, and/or dietary restrictions (vegan, vegetarian, kosher/halal, etc) that may impact your participation in the program. *
PROGRAM AREA: Select the program area you plan to participate in at Legislative Weekend. Legislative members write one-page bills. Press Corps members write articles. [All Middle School participants will be in the Legislative Program. If you are a Chair/Clerk or Presiding Officer, select Legislative.]*
I acknowledge that as a member of the Legislative Branch I MUST author or co-author an original bill to participate at Legislative Weekend OR I acknowledge that as a member of the Press Corps I MUST submit an article to participate at Legislative Weekend. Bill writing resources can be found at https://www.dcyag.org/bill-writing-resources/*
Yes
N/A (Executive / Middle School)
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*

Phone*
Second Participant's Date of Birth*
Second Participant's Registration

Name of school: *

Name of Adult Advisor / Chaperone *
Grade Level:*
This will be my _____ year in Youth and Government.*

Participant's Email Address *

Name of Emergency Contact *

Phone Number of Emergency Contact *

Email of Emergency Contact *

Please list any allergies, medical care, and/or dietary restrictions (vegan, vegetarian, kosher/halal, etc) that may impact your participation in the program. *
PROGRAM AREA: Select the program area you plan to participate in at Legislative Weekend. Legislative members write one-page bills. Press Corps members write articles. [All Middle School participants will be in the Legislative Program. If you are a Chair/Clerk or Presiding Officer, select Legislative.]*
I acknowledge that as a member of the Legislative Branch I MUST author or co-author an original bill to participate at Legislative Weekend OR I acknowledge that as a member of the Press Corps I MUST submit an article to participate at Legislative Weekend. Bill writing resources can be found at https://www.dcyag.org/bill-writing-resources/*
Yes
N/A (Executive / Middle School)
Second Participant's Signature*
Third Participant's Name

First Name*

Last Name*

Phone*
Third Participant's Date of Birth*
Third Participant's Registration

Name of school: *

Name of Adult Advisor / Chaperone *
Grade Level:*
This will be my _____ year in Youth and Government.*

Participant's Email Address *

Name of Emergency Contact *

Phone Number of Emergency Contact *

Email of Emergency Contact *

Please list any allergies, medical care, and/or dietary restrictions (vegan, vegetarian, kosher/halal, etc) that may impact your participation in the program. *
PROGRAM AREA: Select the program area you plan to participate in at Legislative Weekend. Legislative members write one-page bills. Press Corps members write articles. [All Middle School participants will be in the Legislative Program. If you are a Chair/Clerk or Presiding Officer, select Legislative.]*
I acknowledge that as a member of the Legislative Branch I MUST author or co-author an original bill to participate at Legislative Weekend OR I acknowledge that as a member of the Press Corps I MUST submit an article to participate at Legislative Weekend. Bill writing resources can be found at https://www.dcyag.org/bill-writing-resources/*
Yes
N/A (Executive / Middle School)
Third Participant's Signature*
Fourth Participant's Name

First Name*

Last Name*

Phone*
Fourth Participant's Date of Birth*
Fourth Participant's Registration

Name of school: *

Name of Adult Advisor / Chaperone *
Grade Level:*
This will be my _____ year in Youth and Government.*

Participant's Email Address *

Name of Emergency Contact *

Phone Number of Emergency Contact *

Email of Emergency Contact *

Please list any allergies, medical care, and/or dietary restrictions (vegan, vegetarian, kosher/halal, etc) that may impact your participation in the program. *
PROGRAM AREA: Select the program area you plan to participate in at Legislative Weekend. Legislative members write one-page bills. Press Corps members write articles. [All Middle School participants will be in the Legislative Program. If you are a Chair/Clerk or Presiding Officer, select Legislative.]*
I acknowledge that as a member of the Legislative Branch I MUST author or co-author an original bill to participate at Legislative Weekend OR I acknowledge that as a member of the Press Corps I MUST submit an article to participate at Legislative Weekend. Bill writing resources can be found at https://www.dcyag.org/bill-writing-resources/*
Yes
N/A (Executive / Middle School)
Fourth Participant's Signature*
Fifth Participant's Name

First Name*

Last Name*

Phone*
Fifth Participant's Date of Birth*
Fifth Participant's Registration

Name of school: *

Name of Adult Advisor / Chaperone *
Grade Level:*
This will be my _____ year in Youth and Government.*

Participant's Email Address *

Name of Emergency Contact *

Phone Number of Emergency Contact *

Email of Emergency Contact *

Please list any allergies, medical care, and/or dietary restrictions (vegan, vegetarian, kosher/halal, etc) that may impact your participation in the program. *
PROGRAM AREA: Select the program area you plan to participate in at Legislative Weekend. Legislative members write one-page bills. Press Corps members write articles. [All Middle School participants will be in the Legislative Program. If you are a Chair/Clerk or Presiding Officer, select Legislative.]*
I acknowledge that as a member of the Legislative Branch I MUST author or co-author an original bill to participate at Legislative Weekend OR I acknowledge that as a member of the Press Corps I MUST submit an article to participate at Legislative Weekend. Bill writing resources can be found at https://www.dcyag.org/bill-writing-resources/*
Yes
N/A (Executive / Middle School)
Fifth Participant's Signature*
Sixth Participant's Name

First Name*

Last Name*

Phone*
Sixth Participant's Date of Birth*
Sixth Participant's Registration

Name of school: *

Name of Adult Advisor / Chaperone *
Grade Level:*
This will be my _____ year in Youth and Government.*

Participant's Email Address *

Name of Emergency Contact *

Phone Number of Emergency Contact *

Email of Emergency Contact *

Please list any allergies, medical care, and/or dietary restrictions (vegan, vegetarian, kosher/halal, etc) that may impact your participation in the program. *
PROGRAM AREA: Select the program area you plan to participate in at Legislative Weekend. Legislative members write one-page bills. Press Corps members write articles. [All Middle School participants will be in the Legislative Program. If you are a Chair/Clerk or Presiding Officer, select Legislative.]*
I acknowledge that as a member of the Legislative Branch I MUST author or co-author an original bill to participate at Legislative Weekend OR I acknowledge that as a member of the Press Corps I MUST submit an article to participate at Legislative Weekend. Bill writing resources can be found at https://www.dcyag.org/bill-writing-resources/*
Yes
N/A (Executive / Middle School)
Sixth Participant's Signature*
Seventh Participant's Name

First Name*

Last Name*

Phone*
Seventh Participant's Date of Birth*
Seventh Participant's Registration

Name of school: *

Name of Adult Advisor / Chaperone *
Grade Level:*
This will be my _____ year in Youth and Government.*

Participant's Email Address *

Name of Emergency Contact *

Phone Number of Emergency Contact *

Email of Emergency Contact *

Please list any allergies, medical care, and/or dietary restrictions (vegan, vegetarian, kosher/halal, etc) that may impact your participation in the program. *
PROGRAM AREA: Select the program area you plan to participate in at Legislative Weekend. Legislative members write one-page bills. Press Corps members write articles. [All Middle School participants will be in the Legislative Program. If you are a Chair/Clerk or Presiding Officer, select Legislative.]*
I acknowledge that as a member of the Legislative Branch I MUST author or co-author an original bill to participate at Legislative Weekend OR I acknowledge that as a member of the Press Corps I MUST submit an article to participate at Legislative Weekend. Bill writing resources can be found at https://www.dcyag.org/bill-writing-resources/*
Yes
N/A (Executive / Middle School)
Seventh Participant's Signature*
Eighth Participant's Name

First Name*

Last Name*

Phone*
Eighth Participant's Date of Birth*
Eighth Participant's Registration

Name of school: *

Name of Adult Advisor / Chaperone *
Grade Level:*
This will be my _____ year in Youth and Government.*

Participant's Email Address *

Name of Emergency Contact *

Phone Number of Emergency Contact *

Email of Emergency Contact *

Please list any allergies, medical care, and/or dietary restrictions (vegan, vegetarian, kosher/halal, etc) that may impact your participation in the program. *
PROGRAM AREA: Select the program area you plan to participate in at Legislative Weekend. Legislative members write one-page bills. Press Corps members write articles. [All Middle School participants will be in the Legislative Program. If you are a Chair/Clerk or Presiding Officer, select Legislative.]*
I acknowledge that as a member of the Legislative Branch I MUST author or co-author an original bill to participate at Legislative Weekend OR I acknowledge that as a member of the Press Corps I MUST submit an article to participate at Legislative Weekend. Bill writing resources can be found at https://www.dcyag.org/bill-writing-resources/*
Yes
N/A (Executive / Middle School)
Eighth Participant's Signature*
Ninth Participant's Name

First Name*

Last Name*

Phone*
Ninth Participant's Date of Birth*
Ninth Participant's Registration

Name of school: *

Name of Adult Advisor / Chaperone *
Grade Level:*
This will be my _____ year in Youth and Government.*

Participant's Email Address *

Name of Emergency Contact *

Phone Number of Emergency Contact *

Email of Emergency Contact *

Please list any allergies, medical care, and/or dietary restrictions (vegan, vegetarian, kosher/halal, etc) that may impact your participation in the program. *
PROGRAM AREA: Select the program area you plan to participate in at Legislative Weekend. Legislative members write one-page bills. Press Corps members write articles. [All Middle School participants will be in the Legislative Program. If you are a Chair/Clerk or Presiding Officer, select Legislative.]*
I acknowledge that as a member of the Legislative Branch I MUST author or co-author an original bill to participate at Legislative Weekend OR I acknowledge that as a member of the Press Corps I MUST submit an article to participate at Legislative Weekend. Bill writing resources can be found at https://www.dcyag.org/bill-writing-resources/*
Yes
N/A (Executive / Middle School)
Ninth Participant's Signature*
Tenth Participant's Name

First Name*

Last Name*

Phone*
Tenth Participant's Date of Birth*
Tenth Participant's Registration

Name of school: *

Name of Adult Advisor / Chaperone *
Grade Level:*
This will be my _____ year in Youth and Government.*

Participant's Email Address *

Name of Emergency Contact *

Phone Number of Emergency Contact *

Email of Emergency Contact *

Please list any allergies, medical care, and/or dietary restrictions (vegan, vegetarian, kosher/halal, etc) that may impact your participation in the program. *
PROGRAM AREA: Select the program area you plan to participate in at Legislative Weekend. Legislative members write one-page bills. Press Corps members write articles. [All Middle School participants will be in the Legislative Program. If you are a Chair/Clerk or Presiding Officer, select Legislative.]*
I acknowledge that as a member of the Legislative Branch I MUST author or co-author an original bill to participate at Legislative Weekend OR I acknowledge that as a member of the Press Corps I MUST submit an article to participate at Legislative Weekend. Bill writing resources can be found at https://www.dcyag.org/bill-writing-resources/*
Yes
N/A (Executive / Middle School)
Tenth Participant's Signature*
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Optional Demographic Information
What is your race and ethnicity?*
What is your gender identity?*

To participate fully, do you need accommodation for a mental or physical disability? If so, please state and we will make a reasonable effort to meet your request. *
Do you receive free and/or reduced meals through your school? *
Yes
No
I don't know
Decline to state
Which Ward of DC do you live in?*
What size (adult unisex style) t-shirt do you wear?
Click to customize drop-down*
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Registration

Name of school: *

Name of Adult Advisor / Chaperone *
Grade Level:*
This will be my _____ year in Youth and Government.*

Participant's Email Address *

Name of Emergency Contact *

Phone Number of Emergency Contact *

Email of Emergency Contact *

Please list any allergies, medical care, and/or dietary restrictions (vegan, vegetarian, kosher/halal, etc) that may impact your participation in the program. *
PROGRAM AREA: Select the program area you plan to participate in at Legislative Weekend. Legislative members write one-page bills. Press Corps members write articles. [All Middle School participants will be in the Legislative Program. If you are a Chair/Clerk or Presiding Officer, select Legislative.]*
I acknowledge that as a member of the Legislative Branch I MUST author or co-author an original bill to participate at Legislative Weekend OR I acknowledge that as a member of the Press Corps I MUST submit an article to participate at Legislative Weekend. Bill writing resources can be found at https://www.dcyag.org/bill-writing-resources/*
Yes
N/A (Executive / Middle School)
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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