RTL YEA Registration

RTL YEA Registration
Please refer to our program FAQs for any relevant questions you may have. You may also reach out to the provided contacts there if you need further help.
Contact Information
Participant Name

First NameLast Name
What is the name of the youth group you are part of?
This program is for young people ages 14-18. How old will you be on June 16, 2026?
Participant Email
example@example.com
Participant Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Participant Phone Number
Participant Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Participant Address
Parent/Guardian Name

First NameLast Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone Number
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please tell us how you found out about this program?
Participation
What are you hoping to get out of participating in this program?
This program includes 8 live online sessions, weekly peer calls, time to try out new tools in real life, and a shared commitment to be engaged throughout. How will you make space in your schedule so you can fully show up and take part?
Do you have an adult ally that can support your participation? If not, do you want support identifying one?
Learning Project
In a few sentences, please tell us about your project. A project is a real issue or idea you care about improving in your school or community, such as a campaign, event, program, or change you want to create, that you will actively work on during the program. What are you working on? What are you hoping to change or make better?
What values is your project based on? For example, equity, compassion, dignity, well-being, authenticity.
Payment

We are committed to making RTL YEA accessible to all youth and are offering a tiered tuition model. The full cost to provide this seven week leadership program is approximately $1,500 per participant. If your organization, youth group, or family is able to pay the full cost, we strongly encourage you to do so. This helps us offer reduced tuition to participants who need financial support. Which tuition tier are you requesting?
Tuition, Contributions, and Scholarship
prevnext( X )
$3,000 (Full Tuition for You & Sponsorship for One Additional Participant)
$3,000.00



$1,500 Full Tuition
$1,500.00



$500 Contribution
$500.00



$250 Contribution
$250.00



$100 Contribution
$100.00



Full Scholarship Request
Free



Total

$0.00
Optional Demographics

One of Us and Impact Launch value diversity and the lived experiences that come with holding different identities. The following demographic questions are optional and are meant to help us understand who we are reaching and how well our program reflects the diversity of our communities.
How would you describe your gender identity?
What pronouns do you like others to use for you?
How would you describe your race/ethnicity?

Parent/Guardian Consent
Thank you for supporting your young person’s participation in the Radical Transformational Leadership (RTL) Youth Program hosted by One of Us Global Foundation and Impact Launch.

This page provides parental/guardian consent for participation in the program and includes a media release and liability acknowledgement.
Participant Information
Participant Name

First NameLast Name
Participant Age
Parent/Guardian Name

First NameLast Name
Parent/Guardian Email
example@example.com
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact
Emergency Contact Name

First NameLast Name
Relationship to Participant
Emergency Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Participant Consent
Consent Statement

I give permission for my child listed above to participate in the Radical Transformational Leadership (RTL) Youth Program, hosted by One of Us Global Foundation and Impact Launch.

I understand the program includes virtual sessions, group discussions, and collaborative learning activities.
Do you give permission for your child to participate?
Media Release
Media Permission
Liability Acknowledgement
Participation in the RTL Youth Program is voluntary. I understand that One of Us Global Foundation and Impact Launch are not responsible for personal injury, loss, or damage to personal property that may occur before, during, or after program activities.
Signature
Parent/Guardian Confirmation
Parent/Guardian Full Name
Date

MonthDayYear
Should be Empty:

RTL YEA Registration

Contact Information

Participation

Learning Project

Payment

Tuition, Contributions, and Scholarship*

Optional Demographics

Parent/Guardian Consent

Participant Information

Emergency Contact

Participant Consent

Media Release

Liability Acknowledgement

Signature

Tuition, Contributions, and Scholarship