POH Camp | Online 2020

Power of Hope
POH Camp | Online 2020 is for youth, ages 14-19.

This form should be completed by both the youth and the guardian - page 1 is for the youth, page 2 is for the guardian, page 3 is for making your payment. Participants who are 18 years or older can participate and complete the form without a guardian's permission.

You WILL NOT be able to save the form mid-way through. If you have any problems in submitting this form, please contact info@partnersforyouth.org.

Page 1 - To be completed by the Youth
Youth Contact Information













Please list the address from where you will be participating (we will mail your camp supplies to this address).






About Me

Note: We request ethnicity/race information for the purposes of understanding our population better and fulfilling grant reporting requirements.


Note: Participants must be 14 years old on or before the first day of camp.



Participant’s Consent to Basic Guidelines
The following guidelines have been established for participants of the PYE/Power of Hope Online Program in order to create a safe and respectful environment for everyone.
  • All feelings are welcome in this space.
  • Appreciate yourself and one another.
  • Be willing to entertain simultaneous truths. Rather than proving a point, try to listen to understand, and be willing to agree to disagree. At the same time, if you have a strong belief be willing to stand up for it.
  • Participate in all program sessions in order to build group trust and community.
  • Find a quiet distraction-free space where you will be able to fully participate.
  • I have reliable wifi and a computer, iPhone/Ipad, or equivalent to complete this camp.

Page 2 - To be completed by the Guardian

Guardian Contact Information

Please fill this section out completely so that we can notify you if an emergency situation were to arise while this youth is participating in the program.



Name of person youth lives with:









Other





Page 3 - Payment

Registration Fee
Power of Hope employs a sliding scale as a tool to promote economic justice and provide access to all youth.

Please take a minute to review our Sliding Scale Guide to determine your registration fee - CLICK HERE.

Full price is $250.


Pay by Credit Card






Pay by PayPal
Once you have submitted this form you will be taken to PayPal to make your payment.
Pay by Check

Please mail your payment as soon as possible after submitting this form as it is due before the first camp session begins.


Make your check out to 'PYE' and write the youth's name on the note line of the check.


Mail to:

POH

PO Box 1481

Langley, WA, 98260-1481

USA

PYE/POH Privacy Policy
The personal information collected here is kept confidential and used only in the registration process through the duration of the Power of Hope camp that you have registered for. Your contact information will be stored indefinitely in our registration system as part of your transcript with Partners for Youth Empowerment/Power of Hope. For complete details on PYE's Privacy Policy, visit the website.
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