YEP Summer Expansion Program 2026 - Registration and Consent

YEP Summer Expansion Program 2026 Registration and Informed Consent for Participation
Select The Workshop
Please note: This workshop is open to youth of all abilities and is intended to promote inclusivity, understanding, and compassion for everyone. The question below asking whether your child has intellectual or developmental needs is only being used to help plan appropriate matchups and pairings for the tournament and will not exclude your child from participating. Registrations will be accepted on a first come, first served basis.
Does your child have intellectual or developmental needs?
Youth Information
Youth Name
Youth Preferred Name
Youth Pronouns
Youth Primary Language
Age
Youth Email (if 18+)
example@example.com
Email Group Consent
Is your child receiving Care Management services through Ocean Partnership for Children, Ocean County CMO?
Care Manager Name:
Does Your Child have a Peanut Allergy
Caregiver Information
Caregiver Name
Caregiver Primary Language
Address

Address

Street Address Line 2

City/TownState / Province

Postal / Zip Code
State
Zip Code
Phone Number
Format: (000) 000-0000.
Email Address
example@example.com
Email Group Consent
Do you have reliable transportation to/from the workshop?
NOTE: Please note, transportation is not guaranteed and is available on a first come, first serve basis.
I acknowledge that I can terminate or modify this consent at any time. I will give the group facilitators written notice of my wish to modify or terminate all or any portion of this consent. I understand that OPC is not responsible for any of my personal expenses associated with communicating via electronic messaging or email. By agreeing to be added to the email group, I recognize that electronic communications present risk and are not completely private. I realize that computer hackers can invade email with viruses. I understand that emails may be misdirected, intercepted, or forwarded to unintended recipients. I understand the risks associated with using email.
Youth & Caregiver Group Consent
Youth Signature
Date of Signature

MonthDayYear
Date
Caregiver Signature
Date of Signature

MonthDayYear
Date

Consent To Photograph/Videotape
Youth Name:
Caregiver Name:
Please Choose from the Options Below:
I consent to the following Use/Disclosures
I understand that:

1.       I may refuse to sign this authorization and that it is strictly voluntary.

2.       I may revoke this authorization at any time in writing but if I do, it will not have any effect on any actions taken prior to receiving the revocation

3.       A copy of this Photo Release is available to me and/or my child upon request

I understand that, in the instance of external sources (such as media outlets, newspapers, advocacy groups), Ocean Partnership for Children, Inc. is acting only as the intermediary, making it possible for the aforementioned source(s) to contact me. As such, I relieve and hereby agree to hold Ocean Partnership for Children, Inc. free and harmless from any and all liability arising out of the use and/or release of information; interview; photograph/ videotape/film; and subsequent publication or broadcast. I understand that the interview(s) or photo session(s) are being carried out upon my consent and authorization and so assume full responsibility.
Choose One
This authorization expires on
Youth Signature
Date of Signature

MonthDayYear
Date
Caregiver Signature
Date of Signature

MonthDayYear
Date
Primary Language
Should be Empty:

YEP Summer Expansion Program 2026 Registration and Informed Consent for Participation

Youth Information

Caregiver Information

Youth & Caregiver Group Consent

Consent To Photograph/Videotape