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PYCA Participation Form
Thank you for your interest in Pittsburgh Youth for Climate Action. We generally meet once a month on the third Tuesday from 6pm to 8pm. Currently we are meeting in Oakland at 115 Atwood st. but this is subject to change. PYCA is created with middle to high schoolers in mind. Please complete all the questions below in order to participate in a PYCA meeting or event.
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Email
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Your email
Participant First Name
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Your answer
Participant Last Name
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Your answer
Participant Pronouns (i.e. she/her, he/him, they/them)
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Your answer
Best email address to reach you at
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Your answer
Phone number
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Your answer
Home Address (house number and street)
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Your answer
Birthdate
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MM
/
DD
/
YYYY
School
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Your answer
Current Grade Level
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6th
7th
8th
9th
10th
11th
12th
Other:
What topics related to climate change are you most excited to engage with this year?
Your answer
What PYCA meeting are you RSVPing for?
October 15 - 2028 climate voter
November - TBD
December - TBD
Other:
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Parent/Guardian first and last name
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Your answer
Parent/Guardian email address
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Your answer
I am 18 years of age or older
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yes
no
If you answered no to the previous question, your parent/guardian must complete an additional form that will be sent to them via email in order to participate in this Communitopia program. Please ensure that the email you provided for them above is correct.
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I verify that the parent/guardian email that I provided above is correct.
Required
I am 18 years of age or older. I have fully read, understand, and agree to the terms outlined in Communitopia's Photo/Video Release Form linked here:
https://docs.google.com/document/d/1V_IFAYi53gblPvbmNphMiz7sdAfatyUrOljac1Abppk/edit
(for those under 18, your parents will give permission on their form).
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I am 18 years or older, and I have read, understand, and agree to photo/video release form linked above.
I am under 18 and my parents will sign on their form
Please list any allergies, medical concerns, or health/safety considerations Communitopia staff should be aware of.
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Your answer
How did you learn about Communitopia's programming?
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Your answer
A copy of your responses will be emailed to the address you provided.
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