Philadelphia Yearly Meeting

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

Thank you for registering for the January 27-29 Youth Trip to Washington, DC. This program is for youth in grades 7-12.

Youth will spend the weekend exploring the query, "What does our history mean for us today?" The weekend program will include visits to DC museums (possibilities include The National Museum of the American Indian and the The United States Holocaust Memorial Museum), processing those experiences and worship sharing led by PYM Youth Programs staff, and a program by Friends Committee on National Legislation for the youth. Also: playing and eating and having fun together!

Youth, PYM staff, and Friendly Presences (adult volunteers) will spend Friday and Saturday nights at Friends Place on Capitol Hill. Meals will be a combination of simple meals made at Friends Place and eating out. PYM youth registrants and chaperones will travel by Amtrak train -- see form below.

Costs for travel, meals, and program are included in the registration fee. Cost should not keep anyone away! There are choices below that include asking for PYM Scholarship funding. You are also encouraged to ask for support from your local meeting.

Contact Melinda Wenner Bradley, Director of Programs, at mwennerbradley@pym.org or (215) 241-7171 with any questions about registration or logistics.

If you do not yet have a medical form on file for this year, please fill out the Youth Programs medical/permission form you can find on the PYM website.

Thanks! We look forward to this special experience focused on past and present, witness and stewardship -- in community together!

Registration

Please fill out a separate form for each person you would like to register. If you are registering for the financial aid option, leave the Qty blank and enter your dollar amount in the box to the right of the second section below.

Qty

Description

Amount

Total

I am registering for the Youth Trip to Washington, DC and paying the registration cost of $100.

$100.00

---

Select "1" in the quantity box if you are paying the full amount.

I am registering for the Youth Trip to Washington DC, and I would like to request a partial scholarship. The amount entered on the right is what I can pay.

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I am registering for the Youth Trip to Washington DC and I am requesting a full scholarship in the amount of $100.

I am registering for the Youth Trip to Washington DC and am paying what I am able on site with a check or cash. (Use this option if you do not have a credit card, OR if your meeting is providing registration cost with a check to PYM.)

Donations

Description

Amount

Total

I would like to make a donation to the scholarship fund to help offset the cost of attendance for others.

---

I would like to make a donation to the PYM Annual Fund to help fund this program and others like it.

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Total: $0.00

Participant Information

Participant Name: *

Participant Age: *

Participant Birthday: *

Participant Grade in School/Homeschool: *

Local Meeting & Yearly Meeting Affiliation:

(if applicable)

Emergency Contact Person’s Name: *

Relationship of Emergency Contact: *

Phone Number of Emergency Contact: *

Participant Email:

(if applicable)

Participant Phone Number:

(if applicable)

Parent/Legal Guardian Phone Number: *

Are you:

Vegetarian?

Vegan?

Gluten Free?

Please tell us about any special needs the program participant has so that we can make appropriate accommodations (dietary needs not covered above, allergies, physical limitations, learning differences, gender transitions, etc.)

About the Participant:

Any other comments?

HOW ARE YOU TRAVELING TO/FROM THE GATHERING?

Note: We will depart from the 30th Street Train Station in Philadelphia on Friday afternoon at 5:00pm and return there on Sunday afternoon at 5:00pm. Additional train information will be provided to registered participants and parent/guardian.

I am taking public transit or have a ride to the station.

I can offer ride to others near me or on the way.

I don’t know how I am getting to/from the station and need a ride if possible.

Some information from this form will be included in a list to be emailed out to participants for your carpooling convenience. Please enter your information in the following format here: First Name, Last Name, City, State, Phone, Email

Carpool List Information:

Do you have any special carpooling requests to include in the carpool email? (for instance, “looking for a ride Friday to station and can offer a ride home Sunday”)

Carpooling Requests:

Do you attend a boarding school from which you need special permission to leave in order to attend this Young Friends gathering?

Needs permission for Boarding School:

If yes, please provide the name and contact information of the administrator at your school with whom the Youth Programs staff should be in touch.

School Contact Information:

Any other comments?

YOUNG FRIENDS GUIDELINES AFFIRMATION for HIGH SCHOOL YOUTH

If you are in Grades 9-12, and have never attended a Young Friends gathering before, please download and complete the GUIDELINES AFFIRMATION FORM. It requires both participant and guardian review and signatures. This form only needs to be completed ONCE in a person’s entire time as a Young Friend program participant.

Guideline Review Completed: *

Payer Details

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *