2024 Youth Connections Registration Form

2024 Youth Connections Registration Form
Youth Participant
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Youth Phone Number
Please enter a valid phone number.
Youth Email
example@example.com
Parent / Guardian
Name*

First NameLast Name
Phone Number*
E-mail*
example@example.com
Emergency Contact Information*
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
About the Youth
Does the youth have any allergies or medical conditions that the YC Leader should be aware of? Do they use any mobility or communication devices? *
What is their communication style? (verbal/non-verbal, use of assistive communication device)*
What strategies do you use to motivate the youth? What tips do you have for giving them instructions or providing feedback? *
What advice or information would help make their participation more successful or enjoyable? *
Youth Connection Session Planning
Throughout the summer, the Youth Connections Leader organizes short (1-3) hour time blocks with individuals or small groups. Program fees cover costs associated with activities, staff and program administration.
For 2024, I plan to register the youth in:*

Individual sessions (1 to 1) - $20/hrGroup session - $12.50A combination of Individual and Group sessions
To assist the YC Leader with planning activities, please share more information about the type of activities you would like your youth to participate in.*

Skill DevelopmentRecreation and LeisureCommunity ExplorationVolunteer or Pre-EmploymentSocial Activities
For "Skill Development", please share some example goals or activities your youth might be interested in. (eg. working on road safety, life skills, studying for Driver's License, cooking and baking, use of technology)
For "Recreation and Leisure", please share some examples your youth might be interested in. (eg. walking the trails, taking a yoga class, working out at the gym, participating in a sports league, taking an art class, swimming)
For "Community Exploration", please share some examples your youth might be interested in. (eg. using the library, shopping at Market in the Park, visiting tourist attractions)
For "Volunteer or Pre-Employment", please share some examples your youth might be interested in. (eg. specific volunteer locations, groups or activities, developing a resume or cover letter, learning about jobs in the community)
For "Social Activities", please share some examples your youth might be interested in and who they might be interested in spending time with. (eg. organizing 'get togethers', going out for food or drinks, playing board games with peers, )
Other Information
Most Youth Connection sessions require youth and families to arrange their own transportation to go to and from activities. Individuals eligible for CLKD services who are residents of the Municipality of Kincardine or Huron-Kinloss can utilize Saugeen Mobility for a small fee. Is the youth registered with Saugeen Mobility?*

Yes, the youth is registered with Saugeen MobilityNo, we would like to learn more about registering for Saugeen MobilityNo, we will use other transportation options
In the past, Youth Connections participants have taken day trips to nearby communities and attractions. Please share any favourite trip locations from past years or ideas for future trips. *
Please share any other considerations or information that may assist the Youth Connections leader to support the youth to have a great summer! *
Should be Empty:

2024 Youth Connections Registration Form

Youth Participant

Parent / Guardian

About the Youth

Youth Connection Session Planning

Other Information