This registration is for OK2BME's Youth Groups, both in-person and virtual. 

You only need to register using this survey once, and information for upcoming sessions will be shared with you.

In order to keep our meetings safe and private, you must complete all survey questions below in order to attend. For virtual sessions, the link to the Zoom meeting will be emailed to everyone who signs up before the meeting each week.

Please be sure to fill out all the information correctly 

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* 1. What is your first name?

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* 2. What is your last name/initial?

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* 3. What are your pronouns?

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* 4. What is your date of birth?

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* 5. What city do you live in?

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* 6. Please provide information for an emergency contact. An emergency contact should be a trusted adult.

This person should be a trusted adult that we can contact in case of emergencies. We would use this if an emergency occurred during our group and you were in need of help.

Emergency Contact Name & Phone Number:

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* 7. How should we refer to you if we need to speak to your emergency contact? (name/pronouns)

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* 8. FOR VIRTUAL SESSIONS: What address will you be at during our meeting?

We need to know this in case you experience an emergency and we need to send help.

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* 9. What email address should we use to send Youth Group information to? (please ensure that you have entered the email address correctly and have entered the full email address)

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* 10. Group Consent and Oath of Confidentiality

The OK2BME youth group is a recreational group for youth aged 12-18, run by trained staff and supervised interns.

It is important for each person attending the OK2BME Youth Group to keep what’s shared in the group, “in the group”. This means I will:
· Keep private names and information about other group members and keep private anything said in the group.
· Work out concerns that I have with other group members in the group, not outside of the group.

There are exceptions to group confidentiality:
· if someone tells the group, a group member, or the group facilitators that they are going to hurt themselves or someone else;
· if someone tells the group, a group member, or the group facilitators that they or a child are being hurt (physically, emotionally, or verbally), neglected, or mistreated
· if someone is experiencing a medical emergency and responders need their name and contact info

In each of these cases, the group facilitators are required, by law, to discuss the situation with others in the community. In case of emergency, facilitators may be required to contact your parent/guardian. We will make every attempt to respect your right to privacy regarding your reasons for attending the group.

If someone in the group tells you something about their safety that concerns you, please speak with the group facilitators IMMEDIATELY.

If you experience crisis outside the group please call Here 24/7 (1.844.437.3247), Kids Help Phone (1.800.668.6868), and/or go to your local hospital.

You must agree to these terms in order to attend the group.