Elevate Youth Onboarding Form (Waitlist)
Welcome to the 2026 Elevate Youth Program! This form is designed to gather essential information about participants and ensure we provide a meaningful and engaging experience. Please complete all sections to help us better understand your interests, availability, and any special needs. If you are under 18, a parent or guardian must complete and sign the form. We look forward to having you as part of our program! For more information, visit: https://core6.org/eyc/
Youth Participant Information
Full Legal Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Age
*
This program ONLY for is for youth ages 12-26.
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
SMS Opt-In
By checking this box, you agree to receive text messages from Core 6 related to (program details, case management and events). You may reply STOP to opt-out at any time. Reply w/ "HELP" to (619) 308-6595 for assistance. Messages and data rates may apply. Message frequency will vary
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Parent/ Guardian Information
Required If participant is under 18
Parent/ Guardian Name
First Name
Last Name
Parent/ Guardian Email
example@example.com
Parent/ Guardian Cell Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
SMS Opt-In
By checking this box, you agree to receive text messages from Core 6 related to (program details, case management and events). You may reply STOP to opt-out at any time. Reply w/ "HELP" to (619) 308-6595 for assistance. Messages and data rates may apply. Message frequency will vary
Health & Accessibility Needs: Does your child have any allergies, medical conditions, or accessibility needs we should be aware of?
Yes
No
If yes, please describe:
Media & Photo Release: I give permission for my/my child’s photos and videos to be taken and used for program promotion and social media.
*
Yes, I consent
No, I do not consent
Parent/ Guardian Signature (if under 18)
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Program Interest and Availability
What interests you about the Elevate Youth Program?
Community Engagement
Leadership Development
Life Skills and Personal Development
Substance Use Prevention
Mental Health & Wellness
Do you have any previous experience with youth programs or community initiatives? If yes, please describe:
What days/times are you generally available for program activities?
Weekdays at 5pm
Weekdays at 6pm
Weekdays at 5:30pm
I'm Flexible
Health & Accessibility Needs: Do you have any allergies, medical conditions, or accessibility needs we should be aware of?
Yes
No
If yes, please describe:
Media & Photo Release: I give permission for my photos and videos to be taken and used for program promotion and social media.
*
Yes, I consent
No, I do not consent
Participant Agreement:
*
I understand that by joining the Elevate Youth Program, I commit to active participation, respect for others, and engagement in program activities. I agree to adhere to program guidelines and policies.
Participant Signature
*
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