LGBTQ Young Adult Support Group
1st and 3rd Thursday of each month
6:30 pm
Via Zoom
Contact us at  858-382-9156
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Email *
First Name *
Last  Name *
Discord Username (Use N/A if not in the server) *
Pronouns *
Age *
Phone/Texting Number *
Home Address *
Zip Code *
Emergency Contact Name (this does not have to be a parent, but we prefer for your emergency contact to be a legal adult who could get to you/know where you were in an emergency) *
Emergency Contact Phone Number *
Emergency Contact Relationship To You (your parent, aunt, sibling, etc) *
May we use your name and pronouns with your Emergency Contact? (If not, what should we refer to you as, so we can keep you safe even if you aren't Out?) *
How did you hear about us? *
Community Guidelines:
• This is a peer to peer support group, we are not mental health providers and this isn’t a therapy group; this is a space for you and your peers to connect over shared experience and potentially get some advice when it’s asked for.  

• Be respectful of others and their pronouns - your identities are NOT up for debate here.

• There is a 0-tolerance policy regarding bullying, harassment, and discrimination of any sort.

• If at any point you feel uncomfortable, reach out to a Facilitator.

• We as Facilitators are expected to maintain this space, and that means that we may disable someone’s audio or video if they’re being distracting from the group. That may mean if you’re walking around during group we may ask you to sit down or disable your camera, or if someone else is talking and we can hear an echo, we may mute your mic for you. You’ll be able to turn these back on once it is no longer distracting from whoever is speaking.

• Another of our jobs is to keep you all safe. That means that if you mention someone hurting you or that someone has hurt you in the past, we will have to make a report; if you are suicidal, we will have to follow up; and if you’re talking about hurting someone else, we will have to follow up. Reporting means letting one of our supervisors know what’s going on and as a team we figure out next steps. Sometimes that may also mean filing a CPS report.

• If you want to share something with the group that could potentially be triggering for others, please either say “trigger warning” or put a trigger warning in your message (if written out). After you identify the potential triggers, we’ll give folks a couple of moments to let a facilitator know if they need to step away until that topic ends.

• Other than what we have to share with our supervisors, everything that happens in group stays in group. This means that we will not tell anyone outside of our team who is attending these meetings and that you also can’t tell anyone who is attending these meetings. We also don’t talk about what’s discussed in group with others who aren’t here.

• If you have any questions, please message one of our facilitators and we will be happy to help! You can either use your microphone or the chat function in Zoom to communicate with us, but we do ask that everyone have their cameras turned on. If you do not want your camera on, please let us know now and we will split off into a breakout room so that one facilitator can see your face before joining group. You can turn your camera off after that.

As Facilitators of this space, we are responsible for keeping it safe for everyone who enters it. A few slip-ups now and again is understandable if you catch it when it happens, but consistent violations of these rules will result in disciplinary action as follows:
 - You will be given 2 warnings by a Facilitator if you break any of these guidelines.
 - After your 2nd warning, the Member will be asked to not return to group for a period of time.
 - If the problem persists on return, a Facilitator will be required to ask you to not return to group at all.
 - If the problem persists in the space of the Discord server, access to the server may also be revoked.
 - Facilitators have sole discretion on re-entry to group and may decide to not allow re-entry, but must give reason during the denial process
By checking this box, I acknowledge and agree to follow the community guidelines for the Pod, as presented in the provided document. *
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