2023 Peacekeepers GONA Registration Form Logo
  • Peacekeepers GONA Registration Packet Summer 2023

    Native American Health Center Youth Services
  • Hello NAHC families! We're excited for you to join us for this year's Youth Peacekeepers GONA.

    WHAT IS PEACEKEEPERS GONA? GONA is a retreat designed to strengthen communities and individuals through wellness. The central theme of the GONA is community healing from historical trauma as approached through the experiences of American Indian Youth. GONA emphasizes inclusion and individual responsibility to promote healing in a safe environment. This retreat will lead youth on a personal and community-driven journey. GONA curriculum is a nationally recognized “best practice” by the Substance Abuse and Mental Health Services Administration. Native American Health Center staff and Youth Services department will be facilitating this event. GONA will enable youth to learn self-reliance, ways to empower themselves and learn to live a healthy lifestyle in two worlds of culture and tradition walking in balance. This particular "Peacekeepers GONA" seeks to cultivate leadership skills among Native youth who have already attended a regular GONA in the past.
  • Dates: Monday July 31st - Thursday August 3rd, 2023

  • Location: Nature Bridge Foundation

    Golden Gate National Recreation Area, 1033 Fort Cronkhite, Sausalito, CA 94965
  • Transportation is provided.

     

    Departure:

    Oakland- Youth Services

    3124 International Blvd Suite 202.,

    VANS WILL DEPART AT 8:30am on Monday July 31st 

     

    San Francisco- Youth Services

    160 Capp St.

    VANS WILL DEPART AT 8:30am on Monday July 31st

     

    Return:

    VANS WILL DEPART MARIN HEADLANDS AT 3:00pm on Thursday August 3rd. Arrival time at Oakland or San Francisco NAHC will be contingent upon traffic, please be in contact with youth and/or staff.

  • Parental Consent

    I, parent/guardian, the undersigned give legal custody of the participant named above, a minor, and have given permission for my child to participate in the activities, events and projects for the 2023Youth Gathering of Native Americans. In the event that my child needs emergency medical treatment, I authorize Native American Health Center INC. employees, consultants and/or volunteers to secure the necessary emergency medical treatment to protect the life and health of my child.  I understand that an attempt to contact me will be made prior to any medical treatment being initiated; however I authorize Native American Health Center INC. employees, consultants and/or volunteers to authorize the provision of emergency medical treatment without any consent beyond this Permission Slip where a delay in treatment would not be in the best interest of my child.  It is understood that this authorization is given in advance of any specific diagnosis, treatment, or hospital care being required, but is given to provide authority and power on the part of the above agents to obtain care which a physician in the exercise of her/his best judgment may deem advisable.  The authorization is given pursuant to the provision of Section 25.6 of the Civil Code and Section 1283 of the Health and Safety Code of the State of California. I understand that every effort will be made to protect the wellbeing of my child. However, I agree that in case of accidental injury or illness Native American Health Center INC., the Board of Directors and individual employees, consultants and volunteers will not be liable.  I understand that my child when transported will be assigned to ride in an insured vehicle provided by the Native American Health Center INC. I understand that all drivers of the vehicles will be licensed. 
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  • By submitting the form, I agree to the following privacy and confidentiality statement: I understand that all information shared in the GONA will remain confidential and will not be shared with others without my consent. I also understand that there are conditions under which this confidentiality must be broken and information about my child must be shared with the appropriate individuals. These conditions are as follows: there is a suspicion of child abuse/neglect; the participant is in danger of hurting himself/herself; participant is in danger of hurting another.
  • Things to Expect and General Information

  • Part of the GONA is focused on generosity and this is done by making a gift for someone. If you know you need more than 3 days to make a gift its ok to bring a finished gift from home, such as traditional jewelry or an art piece.

     

    Food is prepared on site by staff at Nature Bridge and served buffet style. Please be mindful to only serve a quantity you know you will eat, as there are other groups who utilize the dining hall. After you are done eating, you are to clean up after yourself and pick up your plates, napkins, etc.
     

    Youth are not allowed to wander off on their own, for ANY reason. Youth are to remain in designated areas depending on the activity for the moment. Example if we are doing a workshop, youth are not to go off to the dorms without adult supervision.
     

    Youth will be sleeping in gender specific dorms with an open floor plan. Please be mindful and respect everyone’s space and personal belongings.
     

    Do not bring any electronic items (tablets, phones, gadgets, etc.)
     

    Youth can bring a traditional clothing like a skirt or nice shirt for activities and/or ceremonies during the GONA. Bring only if it makes you comfortable.
     

    There is NO Wi-Fi and some areas have limited cell phone reception.
     

  • Equipment List

    Bring all of the items below. Take a screenshot or photo of this list to reference later.
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  • PLEASE DO NOT BRING ELECTRONIC DEVICES.

    Cell phones are to call parents only and are NOT be used during workshops, activities, etc. We are not responsible for any lost, stolen, or broken items.
  • Participant Medical Information

  • Please be aware that ALL medication must be self-administered, staff cannot distribute any medications of ANY kind.

  • Informed Consent: GONA Study

    This Informed Consent Form is for parents and caregivers of youth who are invited to participate in a study about GONA. 
  • Study ID: California Reducing Disparities Project

    Dates:  2022-2026

    Study Title: Gathering of Native Americans (GONA)

     

    Principal Investigators:

    Paul Masotti, PhD – Native American Health Center, Community Wellness Department

    paulm@nativehealth.org

    510-434-5448

    3124 International Blvd

    Oakland, CA 94506

    Project Sponsor:  The California Reducing Disparities Project is funded by the California Department of Public Health, Office of Health Equity          

    This Informed Consent Form has two parts:

    Information Sheet (to share information about the study with you)
    Certificate of Consent (for signatures if you agree to take part)
     

    You will be given a copy of these documents.

  • PART I: Information Sheet

    Introduction

    The urban Indian organization that puts on the Gathering of Native Americans (GONA) that your child is attending collects information from your child to help them provide better services to your child and to the larger community.

    They would like to request that you allow your child’s survey information be included in a study. Completing the study surveys is expected to take no more than 30 minutes.

    The study will share data with the California Department of Public Health to see how the GONA works and measuring access to mental health services.

    Completing the surveys for use in the study is voluntary. Your child does not have to participate if you or your child do not want to and your child can still participate in the GONA and any other services that are offered by Native American Health Center.  

    The purpose of this form is to inform you about what information we are asking from your child in the surveys and to give you a choice about if you want your child to participate.

    If some sections are confusing or if there are any words that you do not understand, please ask. We are here to help you understand what this study is about and to decide if you want your child to participate. This is a volunteer study and giving parents and youth a choice is very important.

     

    Purpose of the study

    The primary purpose of the study is to understand more about how GONA helps Native people be healthy and resilient (strong/tough/quick to recover).

     

    When we will collect surveys

    We will ask youth to complete surveys at the beginning of the GONA as well as at the end of the GONA and then six months later. Surveys at the beginning and end of GONA will be done in person and on-site. The follow-ups will either be done in person, over the phone, by mail, or on the Internet. If your child completes the survey online or by mail, they will be asked for an address to send compensation of their choosing (gift card or other item). Additionally, they can pick up their incentive at Native American Health Center at 3124 International Blvd., Oakland, CA. If your child needs someone to help them read the questions on the survey, one of our trained staff will help them.

    Participant Selection

    We are asking all GONA participants to participate in the surveys and everyone is being given options for how, if at all, they want their survey information to be used.

    Voluntary Survey Participation

    Your youth’s participation in completing the surveys is entirely voluntary. If your youth chooses to participate and changes their mind during the GONA or afterwards they may withdraw and stop at any time. Youth may also choose to continue participating but not answer all questions that are asked.

    Risks of Participating in the Study

    Youth will be asked to complete surveys about traditional cultural activities/events and their feelings about their life and future. Most participants find that this is pleasant as the surveys are mostly positive. However, some participants may experience a sense of loss if they are not involved in cultural activities or have never had the opportunity to participate in them. This risk is considered to be small.

    There is a risk that some of your child’s answers will accidentally be viewed by others. We make every effort to avoid this, as we describe below, but there is always a small chance that this will happen.

    There also may be questions that make youth feel uncomfortable, such as how your youth identifies their own gender.

    Benefits of Participating in the Study

    The GONA takes place whether or not you choose to allow your youth to participate.  As a result, youth will receive the same benefits as all others.  Participating in the GONA study will involve completing the surveys on Culture and hope for the Future.    

    Participating in the project will help us learn more about the positive benefits of the GONA. One potential benefit from this project is that it could result in some Native American practices and ceremonies, such as the GONA, becoming more accepted by non-Native leaders and funders. As a result, your participation may provide funding and benefits for other Native Americans in the future. The more people that participate in the study, the stronger the study becomes.

    Reimbursements for Survey Participation

    We will ask youth survey questions on the first and last day of the GONA.  On the last day of GONA, we will provide youth with a monetary incentive valued  between $10-$20 for participating in the surveys. Please connect with Native American Health Center Youth Services staff for more information. To understand how long the benefits last from attending a GONA, we will also re-contact you and your youth 6-months after the GONA.  At this time we will offer an incentive valued at the $20-$25 amount for your youth’s time in answering the questions in person, by mail, or on the internet. If your child completes the survey online or by mail, they will be asked for an address to send compensation of their choosing (gift card or other item). Additionally, they can pick up their incentive at Native American Health Center.

    Confidentiality

    As your child fills out the surveys, we urge him or her to keep the answers private by not showing them to others, and to honor the confidentiality of the others who take the survey by not looking at their responses.  The survey information that is kept confidential. Your youth’s name will not be included on any of the survey forms. All surveys will have an assigned unique number on it instead of your youth’s name. Information tying your youths name to their unique number will be stored in a locked room in a locked cabinet that is separate from the survey. We also take measures to make sure this information is locked in lockboxes in separate locations at the GONA event. The information about your youth’s name and unique number is only accessed by a few trained professional staff at your urban Indian health organization. These professionals keep your youth’s information confidential.    

    Sharing the Study Results

    None of your youth’s personal or individual information will be shared with anyone that is not a key trained professional staff that is there to serve your youth. For the study, only grouped information summarizing all GONA study participants as a whole will be reported. The findings from the study will be shared with you through the local urban Indian organization that conducted the GONA you attended. We will also share grouped information with the California Department of Public Health to demonstrate the effectiveness of the GONA.  We also plan to share the grouped results with other interested Native American communities and organizations throughout the United States by sending reports and through publications and attending conferences. 

    Who to Contact about the Study

    If you have any questions you may ask them now or later, even after the study has started. If you wish to ask questions later, you may contact any of the following:

    Dr. Paul Masotti, Native American Health Center                                                          

    Role: Lead Study Contact for the Native American Health Center, Inc.                                       

    3124 International Blvd.                                               

    Oakland, CA 94506                                                     

    paulm@nativehealth.org  510-434-5448                                         

     

    This proposal has been reviewed and approved by the Pacific Institute for Research and Evaluation (PIRE) Institutional Review Board (IRB). If you wish to find about more about the IRB or have questions about your child’s rights as a research participant, you may contact:

     

    Elizabeth Waiters, PIRE (ewaiters@prev.org or 510-883-5780). This project has also been reviewed by the Community Advisory Board at the Native American Health Center and by staff at the collaborating Native American Health organizations indicated earlier in this document.

  • Evaluation of Programs

    NAHC Youth Services programs are grant-funded by the Oakland Fund for Children and Youth (OFCY). All programs funded by OFCY are required to participate in evaluation and data collection/reporting activities. Part of this requirement is to report on who is served and what types of services participants received. Grantees enter this service information through a secure, password-protected online grant management system. However, no single participant will ever be identified in any evaluation. Data is only used in the aggregate to report program and fund performance. Please sign below to acknowledge your consent that your family's data may be used in data/evaluation purposes. Please also note that you will be asked to participate in follow-up questionnaires and that your participation is vital in our program funding.
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  • Photo/Video Release (optional)

    During your youth's participation in the 2023 GONA, some photos/videos may be taken for promotional purposes. These photographs/video recordings may be used with your permission for OFCY promotional purposes. The evaluation and photos/videos help tell the story of the impact of OFCY funded programs. This helps to inform the Oakland community about the positive benefits resulting from the public investment of OFCY funds to support programs serving children and youth presently and in the future. I give permission for OFCY to use photographs or videos of my child.
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  • GONA Code of Conduct

    Native American Health Center Inc. respectfully request all attendees abide by the Code of Conduct as a condition of their participation in the Youth GONA. The following rules of conduct apply to all youth and adults participating in the 2023 Youth Peacekeepers GONA.
  • Attendees shall conduct themselves in a respectful manner and agree to abide by all GONA rules and instructions conveyed by GONA staff and hosts.

    • All participants (Youth /Adults) will be expected to attend and participate in all scheduled workshops and events, unless they are excused for the following reasons: Illness, restriction due to limited physical or medical reasons.
    • Everyone will show respect and conduct themselves in an honorable manner in the presence of healers, workshops, presenters, and to anyone else who enters the GONA Grounds.
    • Everyone will agree in volunteering and assisting with various GONA responsibilities such as setting up, helping with projects, setting up for the presenters, cleaning up after your meals, and coordination of recreational activities, etc.
    • No fighting, arguing or dangerous horseplay, which might injure another person, will be allowed.
    • No Profane language
    • Participants are restricted to their gender-specific, designated sleeping areas while at the GONA.

     

    The following are prohibited:

    • Alcohol, tobacco, and any kind of illegal, non-prescribed drugs.
    • Weapons of any kind
    • Gang attire and colors, or any clothing considered distasteful or restrictive.
    • Rough horseplay
    • Inappropriate language
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  • Guardians will be contacted and responsible for the transportation and pick up of their youth at the GONA site if disciplinary issues arise.

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