MJP Student Registration 2023-2024
BEWARE: Not all school emails allow outside organizations to reply. This will cause your confirmation email with the website password information to be lost. Before registering, verify your email address will receive emails from Google and the Virginia YMCA.

NOTE: A confirmation email will be sent with a password to access all MJP documents . Do not share your password. 
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Email *
Student First Name *
Student Last Name *
School or YMCA Name *
Advisor Name *
MJP Role *
Parent Name *
Parent Phone Number *
In order to register, the student and parent must agree to the code of conduct listed above (or on the registration page of the MJP website). Check the box below to signify you understand, agree to, and have read the requirements. *
Required
Student Signature *
By typing in your name below, you agree your electronic signature is the legal equivalent to your manual/handwritten signature and agree to the terms and conditions of this registration form. You further agree that any information on this form that is deemed false will void this registration. A false signature can result in legal action.
Parent Signature *
By typing in your name below, you agree your electronic signature is the legal equivalent to your manual/handwritten signature and agree to the terms and conditions of this registration form. You also agree that the YMCA or VBA may contact you in order to verify the parent's signature is authentic. You further agree that any information on this form that is deemed false will void this registration. A false signature can result in legal action.
MJP is dedicated to providing equal opportunity for all participants and hereby affirms its commitment that MJP will be free from discrimination on the basis of race, creed, color, religion, alienage or national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status, veteran status, gender identity, sexual orientation, or genetic information.  If you have any concerns or encounter any situation which is contrary to MJP’s equal opportunity commitments, please immediately contact Spencer Snyder at programs@vaymca.org
A copy of your responses will be emailed to the address you provided.
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