ORY Youth Intake Form

Hi! We are so excited to have you join the OUTright Youth crew! Please fill out the form below to help us learn a little more about you. We cannot wait to get to know you better and support you in your time with us.

Filling out this form indicates that you have read and agreed to the following rules for the OUTright Youth Center:


OUTright Youth Rules/Norms (For Youth and Adults)

  1. Respect the space and each other.

    1. No throwing things at each other.

    2. No running/horseplay.

    3. No defacing property (artwork, stickers, paint, etc.)

    4. Be courteous and attentive with our guests. They are professionals who volunteer their time and talents to come share with us.

    5. Remain in our center during group and exit only through front doors (do not access back doors or alarm will go off.)

  2. Keep discussions PG rated. We have a wide range of age groups present at most times, and need things to be appropriate for ALL ears.

  3. No outing, ever. What happens at ORY stays at ORY and is private.

  4. Speak for yourself - use “I” statements whenever possible in discussions. Everyone is different and deserves to have their opinion and experiences heard and understood.

  5. No social media connections between staff/volunteers and youth, except in group format for our private Discord server. No personal "friending" on Discord between staff/volunteers and youth. See staff to join our Discord server or learn more, with parents’ permission.

  6. Adult supervision is required at all times except for using the restroom, and ONLY ONE PERSON IN THE RESTROOM AT A TIME. No exceptions. 

    1. During a private discussion with an adult, another adult should be present as a witness.

    2. During group, youth must remain in line of sight to at least 1 adult at all times (except when using the restroom.)

  7. Quiet Room: 1 person per quiet room, no exceptions. If an adult is needed in the quiet room, 2 adults must be present with the youth.

  8. No PDA. This is a youth center for community, not a place for dating. Please respect each other and each person’s personal space.

  9. Cleanup: ALL staff, volunteers, and youth should participate in cleanup at the end of each group:

    1. Recyclable plastic, glass, and cans should all go in the sink to be rinsed and dried. If you are unsure what is recyclable, ask an adult. Cardboard and paper should go directly in the recycling bins.

    2. Trash Sweep: Everyone is responsible for the space. When cleanup time is announced, please do a sweep for trash/recyclables in your immediate area (within 10 foot radius). 

    3. Put away whatever you have gotten out. If you are using craft supplies for a group activity, help the staff/volunteers put away the supplies. 

    4. Cleaning surfaces: please wipe down tables and countertops that have been used during group with antibacterial wipes.

  10. Vacuuming: One adult should vacuum the floors after each group.

  11. If you need help with anything, including understanding these rules, ask an adult, particularly the Executive Director.

  12. Failure to follow these rules for a youth will result in a call for parent/guardian to immediately pick you up and you will be restricted from attending the following week. Continued failures to follow the rules will result in being uninvited to the group for the foreseeable future.

    Failure to follow the rules as staff/volunteer will be dealt with immediately by the Executive Director.

HAVE FUN, BE YOURSELF, SPREAD JOY.  😊

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Email *
What location will you attend mostly? You are welcome to attend any group, but we will let you know about specific things in your area.
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ORY Member Number *
ORY Member Handle (Your Unique Username for Sign-In and Membership Purposes) *
Full Name *
Pronouns *
Full Legal Name (For emergencies only) *
Assigned Sex at Birth (for use in emergencies only) *
Sexual Orientation and/or Romantic Orientation (For demographic purposes only) -- the physical, emotional, and/or romantic attraction a person has toward others. Not everyone has a single one, or knows exactly one answer.
Gender Identity (For demographic purposes) -- the internal sense of a person's gender and self, doesn't have to match our outer expression. Could be male, female, a combo, or neither. Some of us are also still figuring it out.
Physical Address *
Email address *
Phone Number *
Do we have permission to contact you? *
What is the best way to contact you? *
Birth Date *
MM
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DD
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YYYY
Age *
Level in School (If any) *
Which school do you attend?  *
Member of LGBTQ+ Club through School?
Allergies (Environmental, Medication, etc. - including intolerances!) *
Medical needs (if any) *
Emergency Contact: Safe Person's Name (this person must be 25 years of age or older, and reachable in case of real emergencies) *
Emergency Contact: Relation to youth (Family member/Family friend/Guardian/etc) *
Emergency Contact: Phone Number *
Emergency Contact: What name and pronouns do they use for you? *
Legal Guardian(s) Name(s) *
Legal Guardian(s) Home Address (if same as above, please re-enter) *
Legal Guardian(s)' Email Address *
Legal Guardian(s)' Phone Number *
What name/pronouns do you go by to your parent(s)/legal guardian(s)? (In case of emergency) *
Are you out to your parents/guardians? *
How did you hear about OUTright Youth? *
ORY posts updates to our youth group events and programming on our private Discord. May we add you to the private Discord? *
If yes, add your Discord handle here!
If no, would you like to be on the Youth Email List for similar updates of events, programming, and resources instead?
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