LFS Newcomer Youth Mentorship Program Registration

The Lethbridge Family Services Youth Mentorship Program is open to any newcomer youth aged 16–24 who would benefit from peer connections and group activities. We connect them with other organizations, programs, schools, and employers in Lethbridge that can support their future. We engage in sports, art activities, workshops, community events, volunteerism, and group outings.

The form below includes registration for the group, as well as a waiver and release for all activities. If the participant is under the age of 18, the form below must be completed by a parent or guardian.

Who is this registration for?

1. Youth Participant Information

Youth Participant Full Name:

First NameLast Name

Preferred Name:

If the participant has a preferred name different from their given name, please type it here.

Youth Participant Birthday: *

Day:

Month:

Year:

Youth Participant Phone Number:

Youth Participant WhatsApp Number (if different from phone number):

Youth Participant Email Address:

Pronouns:

Languages spoken:

Please tell us about any allergies and/or medical needs of the youth participant:

For example: asthma, diabetes, dietary restrictions, or illnesses.

Favourite types of activities and interests:

2. Permission for Activities

Where we go: examples include parks, libraries, the university, Youth One, hiking trips, camping trips, and other places.

Safety: I know that activities have some risks. LFS staff will supervise, but they cannot stop every accident.

3. Medical Help

Alberta Personal Health Number:

4. Photo Permission

Can we take photos or videos of the registered participant during Youth Mentorship Program activities, for our website, Facebook, posters, and promotions?

5. Emergency Contacts

Emergency Contact 1 Full Name:

First NameLast Name

Emergency Contact 1 Phone Number:

Emergency Contact 2 Full Name:

First NameLast Name

Emergency Contact 2 Phone Number:

6. Signature

Parent/Guardian Name:

First NameLast Name

Parent/Guardian Email:

By signing below, I confirm that I am the youth participant listed above, or the parent/guardian of the youth participant listed above, and I give consent to participate in the LFS Youth Mentorship Program.

Youth Mentorship Program Registration, Consent, and Release for Activities

1. Youth Participant Information

2. Permission for Activities

3. Medical Help

4. Photo Permission

5. Emergency Contacts

6. Signature