Powered for Life® Registration
Class Dates: Thursdays starting March 21, 2019 - Hours: 4:30 - 5:45 pm. Program runs 8 weeks.
Class Address: Boerne Family Y.M.C.A. 820 Adler Rd., Boerne, Texas 78006 https://ymcasatx.org/boerne

Dear Parent/Guardian,

Powered for Life (PFL) is an 8-week program and powerful tool to help young people succeed by knowing: who God is, uncovering their gifts and talents, living with hope and a sense of purpose, and learning how to become a responsible adult. Christian Job Corps of Kendall County® (CJC) sponsors this program. It empowers young people to achieve success after high school in the workforce, higher education, and life in general. It is FREE and offered only to youth in grades 11 – 12. Space is limited so please apply early. This 8-week course covers the following topics:

• How to overcome roadblocks
• Conflict resolution skills
• Resumes/Interviewing skills
• Customer service satisfaction
• Higher educational opportunities
• Locating summer/part time entry jobs
• God-given gifts and purpose
• Building healthy relationships
• Strengthening communication skills
• Business and community resources
• Managing money for a secure future
• Right choices that lead to success
• How to live by faith

Please review the Parental Consents no. 1-3. Your submission of this form is your consent of all agreements.
Please direct any questions to Lynn or Monay at (830) 331-9916 or email cjc@cjcboerne.org.
Email *
Application Information
Student's Name *
Student's Current Grade *
Student's High School *
Student's Email *
Student's Telephone No. *
Parent/Guardian Name *
Is this student currently employed? *
Has student ever had a bank account/debit card? *
Parent/Guardian Phone *
Parental Consents
1. I give permission for my child to attend Powered for Life. *
2. I give permission for my child’s photograph, name, and quotations to be used by Christian Job Corps of Kendall County® as part of publicity/marketing activities for the Powered for Life program so that others may know the benefits of this program. I understand this may include newsletters, newspapers, agency brochures, social media, and CJC web site. *
OR - For personal reasons, I cannot allow my child’s information to be made public.
Clear selection
3. I agree to discuss with my child about the importance of keeping other students’ stories and information confidential so that no harm may come to them through any fault of my child’s. *
I give my permission and agree to the above information as selected in order to enhance my child’s experience in the Powered for Life program. I also agree to review the Powered for Life rules with my child. I understand this consent will expire one year from the date my child exits the program. I understand, if I want to rescind this authorization, I must submit in writing (email accepted), my withdrawal of this consent. I further understand that my child may be removed from the program due to non-compliance with the rules of the program. *
Please read and affirm the Powered for Life Student Rules
The attending student agrees to comply with the Powered for Life rules:
1. Willingly listens, learns, and participates in order to achieve personal growth.
2. Attends all scheduled classes in order to fully learn and receive a graduation certificate.
3. Calls or texts the lead program facilitator if an emergency arises and he/she cannot attend.
4. Is on time or ahead of time for the class.
5. Arranges for own transportation.
6. Dresses according to BISD regulations.
7. Communicates respectfully with adults and other students and remembers class is a “no foul-language zone.”
8. Requests immediate private discussion with any of the facilitators to address a concern.
9. Refrains from acting out and disrupting class.
10. Silences and refrains from using cell phone during program
11. Uses student tablets in accordance with instructors’ directions.
12. Abides by BISD rules for a “smoking, drug, and alcohol free zone.”
13. Refrains from soliciting or exchanging money during class time.
14. Maintains confidentiality of all attendees in the program, students and adults, unless suspected as illegal and reportable to authorities.

The CJC staff and volunteers in Powered for Life agree to respect the privacy of each student and his/her family and will keep information confidential. Evidence of any illegal activity, suspected abuse, or harm to self or others will be reported as required by law to the appropriate authorities.

The Board and Staff of Christian Job Corps of Kendall County®
PO Box 363, 316 W. Highland Dr., Boerne, TX 78006
cjc@cjcboerne.org / www.cjcboerne.org / (830) 331-9916
Powered for Life Rules Agreement
I have read and understand the Powered for Life student rules. I agree to discuss them with my child so that he/she may abide by them. *
A copy of your responses will be emailed to the address you provided.
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