LIVE Black Youth Corps
LIVE Black Youth Corps promotes, organizes and advocates for racial equity!

Young people ages 11 to 21 are invited to participate. Complete and submit the application to participate. The application takes less than 5 minutes to complete.

LIVE Black Youth Corps supports young people who organize and advocate for racial justice and equity in their schools, neighborhoods and justice systems.

Participate in monthly workshops lead by Good Journey Youth Leaders and then meet with your LIVE Black Youth Corps to create organizing and advocacy activities to fight racial injustices.

Contact Dionne at 314-229-9079 or dionne.ferguson@goodjourney.orgfo r more information.
Email *
LIVE Black Youth Corps
It is important that racism against Black youth be addressed in youth spaces. In these spaces you are developing a sense of your identity. Racism creates unhealthy conditions and can inhibit your development. Black youth should be able to effectively organize and advocate for yourselves and your peers to address racism, inequity and injustice. This requires Black youth empowered by freedom from internalized racism (accepting the lies told about you) and empowered by your ability to challenge and affect change against racist systems.
Good Journey wants you to LIVE (Leaning Into Value & Equity), and will train Black youth and young adults to use our LIVE organizing model to challenge racism and change racist systems. Following training, you and your peers will be a part of LIVE Black Youth Corps in your school or community and work to develop a plan for your racial justice movement, recruit peers to join, and and organize and advocate for justice.
PLEASE TYPE IN YOUR NAME BELOW AS THE LEGAL PARENT/GUARDIAN PROVIDING CONSENT AS SET OUT ABOVE AND BELOW TO INVOLVE YOUR YOUNG PERSON(S) AS A PART OF THE YCOSAE PROGRAM AND ACTIVITIES: *
CUSTOMARY MEETING LOCATION:
TBD (location will be convenient for youth)
BEGINNING AND ENDING DATES:
LIVE Black Youth Corps will begin in June 2021 and continue through April 2023.
MEETING DAYS:
Workshops will be planned around LIVE Black Youth Corps availability and organizing meetings will be determined by individual groups in schools or communities.
TRANSPORTATION:
Regular transportation used by youth(s) as approved by parents/guardians or special transportation authorized by Good Journey Development Foundation and partners as scheduled.
PLEASE COMPLETE THE FOLLOWING INFORMATION REQUESTED BELOW:
Youth's full name: *
Youth's age: *
2nd Youth's full name:
2nd Youth's age: *
Youth's address - include zip code: *
Parent/Guardian address (if different from youth's address) - include zip code:
Parent/Guardian home number: *
Parent/Guardian cell number: *
Parent/Guardian work number:
Student's cell number:
Parent/Guardian email address:
2nd Parent/Guardian name:
2nd Parent/Guardian address, if different from youth's address - include zip code:
2nd Parent/Guardian home number:
2nd Parent/Guardian cell number:
2nd Parent/Guardian work number:
2nd Parent/Guardian email address:
1. I have been informed of the details related to the transportation of my student(s), and my student has my permission to be transported in the manner described above.
2. I understand that my student(s) will be under supervision by personnel working under the auspices of Good Journey Development Foundation and I agree to instruct my youth(s) to obey all rules, regulations and instructions given by staff, volunteers and/or mentors authorized by Good Journey. I further agree that no authorized personnel shall be held liable for any harm incurred to or by my youth(s) as a result of my student(s)'s deliberate, disobedience of rules, regulations or instructions.
3. The authorized personnel, volunteers and mentors under the auspices of Good Journey will supervise your youth(s) during LIVE Black Youth Corps program sessions, and neither they, nor Good Journey, nor any collaborating organization shall be liable, absent gross negligence on their part.
4. Parents/Guardians and Youth will adhere to the COVID-19 procedures required by Good Journey to keep all participants, staff and volunteers safe.
YOUR SIGNATURE AND DATE (TYPE NAME AND TODAY'S DATE) BELOW INDICATES THAT YOU HAVE READ AND AGREED TO THE AFORESAID AND THAT WE HAVE YOUR PERMISSION FOR YOUR YOUTH(S) TO PARTICIPATE IN THE ACTIVITIES AND TO HAVE TRANSPORTATION PROVIDED AS REQUIRED BY ACTIVITIES (Type name & date to sign below): *
MEDIA RELEASE: I consent to have my youth(s) to be interviewed, photographed, videotaped by authorized parties or designees of Good Journey Development Foundation. I also consent to have my student(s) participate in activities of Good Journey, under the auspices of Good Journey Development Foundation and to have any of the photographs (digital/paper), slides, computer images, videos, slide shows, and/or audio-television interviews used for public relations, news articles, advertising, research and or inclusion on Good Journey affiliated social medial and official websites. As parents/guardians, I waive all rights I may have to any claims for payments or royalties in connection with any of the publicity. I also waive all rights to inspect or approve any photo, video, film, interview as it relates to Good Journey Development Foundation when and if my child is a participant. I further consent to have all negatives and positives, whether prints, video film or sound recordings released to Good Journey Development Foundation, Inc. and recognize that all said materials are the property of Good Journey Development Foundation. *
I declare that I am legally eighteen (18) years or older and legally competent to execute the above media release. I consent to abide by these terms and I have voluntarily signed this document. I consent to hold harmless and release and forever discharge Good Journey Development Foundation from any claims, demands and causes of action which I, my heirs, representatives, executors, administrators or any other persons acting on my behalf of my estate. I hereby certify that by signing this document, I do hereby give my consent without reservation to the Media Release for my youth(s) to be included in media and publicity efforts of Good Journey Development Foundation. My signature (TYPED NAME AND DATE BELOW) on this Media Release authorizes my willing consent hereby. (If you do not give consent, type NO on the line below.) *
A copy of your responses will be emailed to the address you provided.
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