The Fall Youth Creating Bonds Program will be held virtually on Tuesdays at 5pm PT for 6-weeks starting on September 19, 2023.

Rules of Engagement and Contract for Participation in CHYP's Creating Bonds Program for Youth:

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Data Privacy Notice 

We discourage you from sharing personal information (last names, phone numbers, social media accounts, addresses, etc.) and sensitive information (medical or clinical advice or diagnoses). However, we may collect and use in Media Publications the following information, as disclosed in the authorization form you signed permitting us to use this information:

• First name (or alias);
• Image(s);
• Voice;
• Diagnosis (optional); and
• Testimonials.

If you have a concern or question about what you or others are sharing, please feel free to reach out to the CHYP team (admin@mychyp.org).

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I am mindful that my feedback and other contributions to this group will be used to support CHYP’s mission. This may include my first name (or alias), age, writings, photographs, videos, audios, and more to be used throughout CHYP media. I am aware that my participation in CHYP activities is voluntary. I have read through and agree to the rules of engagement. I know that the Zoom is an independent program that will be using as a tool to collaborate and share ideas. I understand this is an optional method of communication that I do not have to use, but if I am added to this group, I agree to all of the above rules.

CHYP Creating Bonds 2023 Program Registration & Payment
Please initial the paragraph below which is applicable to your current situation:
I am 18 years of age or older and I am competent to contract in my own name. I have read the rules above about the Creating Bonds Program, and I fully understand the contents, meaning, and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions to admin@mychyp.org or calling 818-671-0620 prior to signing. I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.:
I am the parent or legal guardian of the child named below. I have read this document before signing below, and I fully understand the contents, meaning, and impact of this release. I understand that I am free to address any specific questions regarding this release by submitting those questions to admin@mychyp.org or calling 818-671-0620 prior to signing. I agree that my failure to do so will be interpreted as a free and knowledgeable acceptance of the terms of this release.:
Date:
Participant’s Name:
Age:
Participant’s Signature:
Parent’s Signature:
Parent’s Phone Number:
Parent’s Email:
Emergency 1 Contact Name:
Relation:
Emergency 1 Contact Phone Number: