Leaders for Change is Foster Youth in Action's annual convening of our FYA Family - young people with experience in foster care and youth-led groups who are organizing across the country to radically change the foster care system in their state and region. It is a time to celebrate each other, build youth organizing and advocacy skills, connect across common issues, and share strategies for a continued movement.

REGISTRATION DEADLINE: September 15th, 2018

Registrant Info
Name of Local Group or Organization
Your answer
Please select
First Name
Your answer
Last Name
Your answer
Gender Pronouns
Your answer
Your answer
Your answer
Your answer
T-Shirt Size
Each participant will receive an L4C shirt with Registration
Accessibility & Accomodations
Please list any information regarding accommodations needed, allergies, medications, and travel preferences
Your answer
Travel Info
To purchase flights, airline regulations require us to collect name, date of birth, and gender as it appears on your State Issued ID, and for now the airlines unfortunately only offer M or F options for gender designation.

This information is confidential and will only be used to purchase flights. If you have different names or genders listed on different State Issued ID it is your choice which one to provide. Make sure to bring the ID that matches the info below to the airport for boarding passes and security.

Full Name as it appears as your Government Issued ID
Your answer
Gender as it appears on your Government -Issued ID
Your answer
Your answer
Please select how you will be getting to L4C
*FYA will purchase all flights and help coordinate ground transportation
What City will you be departing from?
List the City name or the Airport three-letter abbreviation (ex. San Francisco - SFO)
Your answer
Sleeping Arrangements
Please select your roommate preference
We are thrilled to be hosted by the Asilomar Conference Center directly on the beach in Monterey, CA. The conference center has beautiful rooms and participants may be in rooms with 2, 3, and 4 full beds and private bathrooms in each room (no bunk beds). Please select your preference for sharing rooms and we will do our best to coordinate.
Please list any other sleeping & room needs, accommodations, or preferences
Your answer
Child Care
This year L4C welcomes participants who are parenting children, siblings, and/or other family members of all ages to attend the conference (this includes bio parents and those with legal guardianship). Childcare will be provided during conference activities and is generally required for all children who are walkin, talkin, and otherwise not on parents laps.


Will you be bringing a child/children with you?
# of children you are bringing
Your answer
If yes, please list the full name, age, and birthdate of each child below
Your answer
Please select preferred sleeping accomodations
Emergency Contact
Name of Emergency Contact
Your answer
Phone Number of Emergency Contact
Your answer
L4C Communication
Before and during the Conference we will be using a text message service to communicate about important L4C news, notify participants about upcoming workshops and opportunities during the conference, and share info. Participants can opt out at any time.
Can you receive text messages on the phone number you provided and do you agree to receiving notifications about L4C via REMIND Text service?
LEADERSHIP at L4C!! (Staff & Young People)
This year at L4C, we have many opportunities for young people and staff to help be a part of the collective leadership team on the ground at L4C!! Check out these awesome opportunities and if you are interested in learning more, check the box next to the Teams you are most interested in supporting and we will follow up shortly! (You can select up to 3)
Registration Costs & Payment Options
CURRENT AND PENDING MEMBERS: Foster Youth in Action’s national network partners are invited to send a delegation of up to four (4) Members 14-26 and one (1) staff for a total group fee of $800.

Want to bring more than five to the conference? Absolutely! Fees for each additional person above the 5 included in the base fee is $1,200.

NON-MEMBER fees are also $1,200 person.

This rate is less than 15% of the conference cost and is covered by a variety of generous sponsors and donors. FYA will cover flights, all meals, lodging, and activities for this fee. Non-member groups should contact us prior to registering.

(Select “Leaders for Change” under donation options)

By Mail:
Send a check to 2140 Shattuck Avenue, Suite 504, Berkeley, CA, 94704 and made payable to Foster Youth in Action.

We are happy to prepare an invoice for your records.

Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service