Gathering of the Youth: Conference Registration
Gathering of the Youth: Conference Registration


Gathering of the Youth is a 3-day, movement-building youth conference focused on dismantling the school-to-prison pipeline through Juvenile Justice Reform, Gun Violence Prevention, Gender Equity, and Transformative Politics. Gathering of the Youth is being presented by The Gathering for Justice.

The first Gathering of the Youth took place in 2005, immediately after Harry Belafonte convened his peers from the Civil Rights Movement to commit to a Covenant to End Child Incarceration. Following that convening, he brought together youth leaders from across the country to Epps, Alabama for an intergenerational gathering with the elders from the movement. This convening was grounded in community, centered on youth--particularly those directly impacted and honed into intentional organizing--and focused on leadership development and movement-building rooted in Kingian Nonviolence.

Aiming to find the agenda for the next generation of leaders and movement builders in our country, the 2005 Gathering of the Youth highlighted the powerful parallels in their civil and human rights struggles. The message of inclusivity, intersectionality, and the work of uncovering common ground to unite people from diverse communities and cultures is what came out of the 2005 gathering, with a commitment to one another and a larger mission.

The 2019 Gathering of the Youth is our movement’s present day solutions-based convening, bringing together 50 youth leaders from across New York City and the surrounding area; from Friday, October 18 - Sunday, October 20, 2019 at the National Black Theatre in Harlem. Youth leaders will engage in conversations, panel discussions, workshops, trainings, artistic performances and more, while developing an agenda for dismantling the school-to-prison pipeline. Participants will leave inspired and motivated, with new connections, skills and strategies for organizing in their communities.

Gathering of the Youth:
Friday, October 18 - 6:00 - 10:00pm
Saturday, October 19 - 9:00am - 9:00pm
Sunday, October 20 - 8:30am - 2:30pm

National Black Theatre
2031 5th Ave
New York, NY 10035

*There are no drugs or alcohol allowed on the premises.*
*By registering, I grant The Gathering for Justice permission to use any photograph(s) or electronic media images captured at the conference.*
Name *
Your answer
City / Borough *
Your answer
Your answer
Phone Number
Your answer
Age (bring picture ID for registration)* *
Your answer
T-Shirt Size
How did you hear about the Gathering of the Youth Conference?
Your answer
Can you attend all 3 days? (Full participation is mandatory for attendance)* *
If no, what days can you attend?
Gender Pronouns
Your answer
Dietary Restrictions: *
Your answer
Will you need childcare? *childcare provided for children under 12*
If yes, how old is your child? Anything else we need to know about them (allergies, accessibility needs, etc)?
Your answer
Do you have any accessibility needs?
Your answer
Do you need interpretation?
If yes, for what language?
Your answer
I agree to not bring/partake in any drugs or alcohol while on the National Black Theatre premises. *
Are you in high school? Are you under 18? If yes, please continue - we need your parent/legal guardian's permission below.
By checking this box, I, the undersigned parent or legal guardian of the child named above, do hereby grant my permission and consent for the said child to attend and participate in the events and activities of the Gathering of the Youth Conference including the necessary transportation to and from these events and activities. I hereby warrant to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child. In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment if: (1) such care is deemed necessary by the persons in charge of the event; (2) the proposed medical treatment or procedures are immediately or imminently necessary and any delay occasioned by an attempt to obtain my parental consent would reasonably jeopardize the life, health, or well-being of the child affected; (3) I cannot be personally contacted.
By checking this box, I, the undersigned, parent/legal guardian of the child named above do hereby consent to any x-ray exam, anesthetic, medical diagnosis or treatment and hospital services that may be rendered to said minor, under the general or specific instructions of the physician listed or the hospital’s or clinic’s on duty physician. It is understood that this consent is given in advance of any specific diagnosis or treatment and is given to encourage those persons who have temporary custody of my child, in my absence, and said physician to exercise their best judgment as to the requirements of such diagnosis or said medical treatment. I understand that reasonable precautions will be exercised by the adults supervising each event and that adults will adhere to Gathering for Justice policy at all times.
By checking this box, I further agree not to hold The Gathering for Justice and/or Professional supports responsible for any accident that may occur on the way to, from, or during an event. I indemnify, defend and hold harmless The Gathering for Justice for all claims made and liabilities assessed against them as a result of any event or activity. I release The Gathering for Justice and all medical providers from liability in acting on my behalf in this regard and rendering such medical treatment. I assume the risk and financial responsibility for any injury resulting from any event or activity. I understand that any and all medical expenses incurred are my responsibility and that there is not medical insurance coverage provided by The Gathering for Justice
By checking this box, I understand and assume the expenses of any property damage caused by my child. Should it be necessary that my child be returned home due to disciplinary action (when on trips), I will be contacted by the staff of The Gathering for Justice and will be responsible to pick my child up and assume the cost of transportation.This permission shall remain in effect until the end of my child’s participation in the conference or unless terminated in writing by me or if my child is removed from the conference.
By checking this box, I understand that my child may be photographed or recorded on video during the course of the Gathering of the Youth Conference. By initialing below I provide consent for their image to be used in print, electronic, or video form for the promotional purpose of future Gathering for Justice activities. If I do not provide consent, I will check “I do not consent” below.
Parent/legal guardian Name:
Your answer
Parent/legal guardian Phone Number:
Your answer
In case of emergency, please contact (adult other than parent/legal guardian, if available):
Your answer
Emergency contact relationship to participant:
Your answer
Emergency contact Phone Number:
Your answer
Your answer
Phone (for physician):
Your answer
In signing this form, I certify that all information contained herein is true and accurate to the best of my knowledge. (Please write your full name as electronic signature below)
Your answer
Your answer
Never submit passwords through Google Forms.
This form was created inside of The Gathering for Justice. Report Abuse - Terms of Service