2022-23 Commitment Form
The mission of the Germantown Youth Futures Activities Committee is to plan FUN activities for youth in grades 6-12 as an alternative to drugs, alcohol, and tobacco.  We also try to prevent youth violence, help our youth make informed decisions, and volunteer our time to fundraise for family-friendly, positive activities and programs in the community. This helps build positive youth assets, leadership skills and offers an opportunity to share their unique perspectives and youth voice in planning programs and events.

All youth who commit to being a part of the Activities Committee should attend a leadership event.  This event consists of a one-day team building/leadership training session (details shared with members as scheduled). In addition, there will be Activities Committee meetings, typically held on Tuesday/Wednesday evenings once per month. Additional meetings may be scheduled (as needed) for planning larger events.  Communication is primarily conducted through email; please provide an email address that you may receive and respond to communications, as needed.

Each youth member is required to complete this commitment form annually:
  • Returning Members: Due on or before the annual recruitment event held in fall.  
  • New Members: Due by the next scheduled meeting date after you decide to join. 

Please review the information and complete this form if you intend to participate in the Germantown Youth Futures Activities Committee.
Sign in to Google to save your progress. Learn more
First name: *
Last name: *
Grade for 2022-23 school year: *
Student date of birth: *
Student cell phone number: *
Parent cell phone number: *
Student email address: *
Parent email address: *
Address: *
Zip code:
Are there any medical or allergy concerns we should be aware of? *
Shirt Size: *
I will attend and participate in any leadership training sessions. *
I will attend and participate in monthly meetings as scheduled.  I understand that if I cannot attend a meeting that I will call or email to be excused from the meeting.  If I miss four meetings that are not excused, I may be removed from the committee. *
I will treat others with dignity and respect and act in a manner that does not interrupt the meetings, activities, learning or participation of others, including adult leaders and other youth participants. *
As health and safety conditions permit, I will attend and participate in volunteer activities or fundraising activities throughout the year (e.g. helping at summer youth activities, Family Glow Walk, Movies in the Park, Disc Golf Extravaganza, etc.). *
I will try to recruit one or more youth to join the committee. *
Some meetings may be conducted virtually via Zoom. Please select the options below, if they apply to you: (All answers will be kept confidential. We will contact anyone who answers yes to any statement below to find out how we can support your participation in virtual meetings.)
I read the Commitment Form and understand my roles and responsibilities which include remaining alcohol, drug, violence, and tobacco free. If I am in violation of not remaining drug, alcohol, violence or tobacco free the following will occur: 
The individual will be suspended from the committee, they will need to meet with a counselor, and upon the counselor’s recommendation be allowed back on the committee. 
If a second violation occurs the person shall be removed from the committee.
Parents: You are giving permission to Germantown Youth Futures to use your child’s photo in organizational related publications, social media, and on their web site. In addition, you are giving permission for your youth to be surveyed for grant purposes. By entering your full name in the box below, you are digitally signing this form. *
Voluntary Self-Identification of Ethnicity and Race
Germantown Youth Futures invites program participants to identify their ethnicity and race. This information is often required for the organization to apply for various funding opportunities, such as grants.
Are you Hispanic or Latino? *
What is your race? (If you are two or more races, please check all that apply). *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Germantown Youth Futures. Report Abuse