YAC Event Registration and Consent Form

Youth Advisory Community Event Registration and Consent Form
Youth Advisory Community (YAC) events provide opportunities for Arizona Youth Leadership Forum (AZYLF) alumni, ages 14–29, to connect, collaborate, and continue developing leadership skills.

March YAC Gathering – Service Project Day!

Date: Saturday, March 28, 2026
Time: 11:00 AM – 2:00 PM
Location: Pathways to Work, 1445 E. Guadalupe Rd., Tempe, AZ 85283

Join us for our March YAC event! We’ll spend the afternoon working together on a community service project—creating cozy tie blankets to donate to a local organization here in the Valley.

We’ll have music, snacks, and a fun space to connect while giving back.

Come hang out, make something meaningful, and be part of a project that spreads kindness!
AZYLF Confirmation
I have graduated from Arizona Youth Leadership Forum (AZYLF):*

YesNo
Event Selection
I would like to attend:*

March 28th: Service Project Day
Participant's Information
Participant's Name*

Participant First NameParticipant Last Name
Please provide the best phone number to reach you on the day of the event in case we need to contact you.*
Please enter a valid phone number.
Email*
example@example.com
County of Residence*
Are you under 18 years old/do you have a legal guardian?*

YesNo
Parent/Guardian Information
Parent/Guardian Name*

Parent/Guardian First NameParent/Guardian Last Name
Parent/Guardian Phone Number*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
Acommodations
We are committed to making our events accessible to everyone. Please describe any disability accommodations needed to participate in this event. Note: Advance notice may be required to arrange for some accessibility needs.
Allergies and Dietary Restrictions
Do you have any allergies (food, medication, environmental, etc.)?*

YesNo
Please list and explain any allergies (food, medication, environmental, etc.).*

0/150
Do you have any dietary restrictions?*

YesNo
Please list and explain any dietary restrictions.*

0/150
Emergency Contact Information
Emergency Contact Name*

First NameLast Name
Emergency Contact 1 Phone Number*
Please enter a valid phone number
Emergency Contact 1 Relationship to Applicant*
Participant Release and Consent

Please read the Participant Release and Consent Statement and check the corresponding boxes to confirm your understanding and agreement.
Diverse Ability Incorporated will not provide transportation to Youth Advisory Community (YAC) events.*

I understand and acknowledge that I am responsible for my transportation to and from the event.
Each participant is responsible for the $25 admission fee for Tohono Chul’s Holiday Nights.*

I understand and acknowledge that I am responsible for all costs associated with participating in this event.
Faire at the Square is a free event; however, participants are responsible for any additional purchases they choose to make during the event.*

I understand and acknowledge that I am responsible for all costs associated with participating in this event.
Participant Release and Consent*
Signature and Acknowledgement
By typing my full name below and submitting this form electronically, I confirm that I have read and understood the contents of this form, and that all information provided is true and accurate to the best of my knowledge. I understand that my typed name constitutes a legal electronic signature and signifies my consent and agreement to the terms outlined above.*
Participant first and last name above to consent
Date Signed*

MonthDayYear
By typing my full name below and submitting this form electronically, I acknowledge that I am the parent or legal guardian of the Participant. I confirm that I have read and understood the contents of this form, and that all information provided is true and accurate to the best of my knowledge. I understand that my typed name constitutes a legal electronic signature and signifies my consent and agreement to the terms outlined above.*
Parent first and last name above to consent
Date Signed*

MonthDayYear
If you have difficulty completing this online form, please email us or call 602-425-5135.
Should be Empty:

Youth Advisory Community Event Registration and Consent Form

AZYLF Confirmation

Event Selection

Participant's Information

Parent/Guardian Information

Acommodations

Allergies and Dietary Restrictions

Emergency Contact Information

Participant Release and Consent

Signature and Acknowledgement