Clone of "Rise Up Young Men" Teen Summit
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  • "RISE UP YOUNG MEN!" TEEN SUMMIT

    Registration - Page 1

  • Registration Form

    May 10th, 2024 Tulsa Dream Center 200 W 46th St., Tulsa Oklahoma 74126

  • PARTICIPANT INFORMATION
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  • Student Workshop (Electives)

    *If a participant is more than 30 minutes late he will lose his spot in one or possibly both sessions. Participants cannot change sessions on arrival.

  • Transportation

  • Parent Guardian Information

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  • Please select a Parent Workshop below.

    If you will not be attend the Parent Workshops skip to the next question.

  • LOCAL EMERGENCY CONTACT

    Provide as much information as possible
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  • "RISE UP YOUNG MEN!" TEEN SUMMIT

    Registration - Page 2

  • Acknowledgements & Releases

  • CAREFULLY READ AND COMPLETE THE REQUIRED ACKNOWLEDGEMENTS BELOW


    ➔ The above information is true to the best of my knowledge. As the parent/guardian of the above-named participant, I give permission for my child to participate in all "RISE UP YOUNG MEN!" TEEN SUMMIT activities. My child has my permission to be transported to and from this activity. I understand that neither the "RISE UP YOUNG MEN!" TEEN SUMMIT and/or the Tulsa Dream Center, nor any of its agents are responsible for any injury or casualty sustained by my child. If a medical emergency occurs and I cannot be reached or my child needs immediate care, I authorize the staff of Soaring Eagles and the Dream Center to use their best judgment in taking my child to a hospital and/or contacting a medical professional. I further agree to be responsible for any charges incurred in relation to obtaining such medical care.

  • PHOTOGRAPHY RELEASE:

    ➔ During the course of the "RISE UP YOUNG MEN!" TEEN SUMMIT activities., photos and or video will be taken. Please indicate below if you give permission to use and/or publish photos/video of you or your youth obtained during the event.

     

  • ➔ All attendees will be responsible for any personal items brought to the event. "RISE UP YOUNG MEN!" TEEN SUMMIT, Soaring Eagles Youth and Family Services, 100 Black Men of Tulsa, Tulsa Dream Center and any of their agents, representatives, and/or volunteers will not be responsible for lost or stolen items. Disruptive conduct will not be tolerated. Any attendees who are deemed to be unruly or disorderly will be required to leave the premises. Transportation from the event will be the responsibility of the parent/guardian.

  • ➔ We at Soaring Eagles Youth & Family Services encourages young men to seek out and get connected with organizations that provide various services that help positively impact the lives of each young man. While we encourage connecting with mentors, we advise that the young men first connect with an official organization and through the organization to be partnered with an individual mentor. We do NOT advise young men to exchange numbers with event volunteers. Should your child exchange numbers with an event volunteer, Soaring Eagles Youth & Family Services, The Tulsa Dream Center, 100 Black Men of Tulsa, and any other company or organization connected to "RISE UP YOUNG MEN!" TEEN SUMMIT shall NOT be held liable for the outcome of relationship.

  • IMPORTANT:

    Please ensure all appropriate check-boxes are completed above and sign and date this form below.

  • The undersigned parent/guardian hereby releases Soaring Eagles Youth & Family Services, 100 Black Men of Tulsa, and The Tulsa Dream Center its employees, agents, Board of Directors, and their respective successors and assigns from any and all claims, damages and liabilities, including, without limitation, personal injury, bodily injury, and damage to, or loss of, personal property, including and all costs or expenses related thereto, without limitation, which may be incurred by the undersigned and/or the child identified herein, as the direct or indirect result or consequence for any event which may occur or arise from the attendance and/or participation of the child identified herein, in the event described above, including transportation to and from said event.

     

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  • Health Self Screening Declaration Form

    Health Self Screening Declaration Form

    Soaring Eagle’s Youth and Family Service’s

  • *Please complete a separate form for each student.

    Soaring Eagle’s Youth and Family Service’s. Inc., 100 Black Men of Tulsa, and Tulsa Dream Center is dedicated to the health and safety of our teens and volunteers. Parent/guardians’ commitment to keep their kids home from the "RISE UP YOUNG MEN!" TEEN SUMMIT under the circumstances listed below is a very important part of keeping the "RISE UP YOUNG MEN!" TEEN SUMMIT at the Tulsa Dream Center healthy and sustaining uninterrupted in-person learning.

    By signing this form, you acknowledge your responsibility and agreement for the "RISE UP YOUNG MEN!" TEEN SUMMIT to keep your teen home if:

    1. A member of the household is positive for COVID-19 or is awaiting test results after having had contact with a positive case of COVID-19.

    2. A member of the household is experiencing COVID-like symptoms.

    3. Student has had close contact with someone diagnosed with COVID-19 within 14 days.

    4. Student is experiencing fever of 100 degrees or higher.

    5. Student is experiencing any of the following unexplained symptoms (fever or chills, cough, shortness of breath, fatigue, muscle or body aches, sore throat, congestion or runny nose, nausea or vomiting,diarrhea, headache, loss of taste or smell).

    Should any of the above apply to your teen, please refer to your healthcare provider for testing and care and contact the Executive Director Premadonna Braddick by phone (918-739-8336).

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