Radical Monarchs Participant Application
Radical Monarchs Application Checklist
(For 3rd-5th Grade Girl*-Identified Youth)

To complete the application process, please review all sections of this application checklist carefully:

1. Radical Monarch Application & Family Questionnaire (below)
2. Signed Expectations & Community Agreements Form (below)
3. Signed Assumption of Risk, Release & Consent to Participate Agreement (below)
4. Attend Mandatory Interview & Orientation

**Girls refers to gender-expansive youth (cis girls, trans girls, non-binary youth, gender non-conforming youth, gender queer youth and any girl-identified youth).
Radical Monarch Application and Questionnaire
Full Name *
Preferred Name
Gender Pronoun *
Race/Ethnicity(s) *
Which troop(s) are you interested in joining? (Check all that apply) *
Parent/Guardian Full Name *
Parent/Guardian Full Name
Home Address (including city/state/zip code) *
Phone # *
Email *
School *
Current Grade *
Date of Birth *
My child needs ASL translation *
My child receives free or reduced lunch *
Other needs? (food allergies, accessibility, etc)
Please tell us any other identities you are comfortable sharing. For example, gender identity, primary language, disability, etc. (This information will only be used to ensure diverse participation and to set troop needs up for success)
Does your child have a 504 plan and/or an IEP? If so, what does your child need to learn and participate at their best?
What else would you like us to know? Questions?
Family Point Person Name (in charge of communicating with Radical Monarchs Troop Leaders) *
Point Person's Phone # *
Point Person's Email *
Additional Family Point Person Name (in charge of communicating with Radical Monarchs Troop Leaders)
Additional Point Person's Phone #
Additional Point Person's Email
Questions for Potential Radical Monarch
5 sentences minimum per answer
Explain why you want to be a Radical Monarch? How do you think the program will benefit you? What will you contribute to the group? *
The thing that makes me different from most people is…. *
What are your passions? What motivates and excites you? *
Family Questionnaire
5 sentences minimum per answer
Why do you want your child to be in the Radical Monarchs? What will you as parent(s)/guardian(s) contribute to the Radical Monarch Parent/Guardian Community? *
All of the Radical Badges the Monarchs earn are based on the principles of social justice which we define as equity and inclusion of all people. For example, some of the badges earned include: Black Lives Matter, Radical Pride (LGBTQ Ally), and Pachamama Justice to name a few. How will you reinforce the social justice principles of equality and inclusion within your family? *
We understand that the Radical Monarchs is one of many special activities that you can participate in. List other extracurricular activities your child is involved in. *
Please identify any potential challenges that might affect their attendance and share how you plan to overcome them so that they can fully participate in Radical Monarchs. Examples can include: providing athletic schedules in advance, communicating early with the Radical Troop Leaders and asking for additional information when needed. *
Radical Monarch Expectations and Community Agreements
Families: We agree to...

Meet the mandatory 90% attendance requirement for all Radical Troop meetings which includes the Badge Awards Ceremony meeting.

Communicate all non emergency absences in advance, and understand that a radical badge will not be awarded if the 90% attendance requirement is not met. The Radical Monarch curriculum is designed to build and connect towards a Radical Badge awards ceremony, therefore attendance is essential.

Follow the attendance protocol, if attendance becomes a concern we agree to participate in the following steps:
1st absence: Parent/Guardian Check-In
2nd absence: Family Meeting to problem solve attendance issues
3rd absence: Dismissal from the program

Drop off Radical Monarch(s) on time for all Troop meetings.

Review the Radical Monarchs Troop meeting schedule in advance and be proactive about problem solving any Troop meeting conflicts in order to meet the attendance requirement. Radical Troop Leaders understand that a commitment to attend all troop meetings sometimes requires sacrificing family commitments, athletics, and youth groups which is why we ask that you plan ahead and prioritize Radical Monarch troop meetings.

Respond within 48hrs to all Radical Monarch emails/texts in order to help the Radical Troop Leaders with scheduling dates for troop meetings and to be aware of important information.

If I am a white ally parent/guardian I agree to participate in mandatory Radical Monarch ally development round tables held 3 times per year. The goal of this training is twofold: to explore what my role is as a Radical Monarch family, and to intentionally deepen my white ally best practices.

Monarchs: I agree to...
Brave Space: I promise to lean into my stretch zone and advocate for myself

One Diva One Mic : Listen with my whole body while someone is talking

Take Space Make Space: If I talk often I will make space for others to share, if I listen often I will take space and share my thoughts with the troop.

Put Ups : Be generous with compliments/positive feedback

Have Fun : Be open to learning and trying new things

Wear & keep track of my Radical Monarch uniform (beret and vest)

Please Sign and Date Below to confirm you have read and understand the information above.

Assumption of Risk, Release, Indemnity and Consent to Participate Agreement
During the course of The Radical Monarchs Program, or as may be applicable to your student, The Radical Monarchs may participate in athletic play, swimming, camping, overnight trips, and use of Radical Monarch equipment, or other on-site or off-site activities. Participation in The Radical Monarchs is associated with inherent risks.

The risks associated with participation in The Radical Monarchs, may range from minor to severe injuries, illness, disease, disability, or death. Inherent risks may be compounded by a Monarch’s failure to strictly follow safety guidelines or instructions. Circumstances could require immediate medical attention. In the event that a parent or guardian cannot be timely consulted during a medical emergency, I agree The Radical Monarchs its employees, agents, or representatives may authorize treatment by licensed medical, dental or emergency response professionals. I agree to be financially responsible for such medical, dental or emergency care.

For information I want to obtain regarding specific risks or activities, I agree to ask questions via email before signing this Agreement and permitting my child or ward to participate in The Radical Monarchs.

A participant’s failure to abide by The Radical Monarchs rules and rules associated with a specific activity, as well as other behavioral expectations, may result in a Radical Monarch being sent home. Should this be necessary, the parent or guardian will be responsible for any and all costs incurred. In addition, the parent or guardian will be responsible for transporting the student back home.

In consideration of The Radical Monarchs permitting my child or ward to participate in the program I agree for myself and on behalf of my child or ward to: (1) assume all of the risks of injury, loss, kidnapping, assault, child run-away, illness, disease, disability, disfigurement, or death of my child or ward arising from their participation and all related events or incidents; (2) release, waive, discharge, and covenant not to sue The Radical Monarchs and its board of trustees, officers, employees, agents, volunteers, chaperones, and representatives as to all losses, damages, rights, claims, demands, and liabilities arising out of or related to my child's or ward's participation and all related events or incidents; and (3) indemnify and hold harmless The Radical Monarchs and its trustees, officers, employees, agents, volunteers, chaperones and representatives from all claims, actions, suits, costs, expenses, attorney's' fees, damages, and liabilities as a direct or indirect consequence of participation by my child or ward.

Both parents and legal guardians must sign this Agreement before a student may participate. If only one parent/guardian is living or has sole legal custody, then only that person needs to sign. The signing parent or guardian, however, shall notify the noncustodial parent or guardian of the contents of this Agreement before signing and submitting it. Any failure of both parents and legal guardians to sign this Agreement shall nonetheless bind my child to its terms and conditions.
Please indicate whether one or more of the child's parents/guardians are white. *
Parent/Guardian Signature (by typing your full name here you are agreeing to the expectations and community agreements) *
Youth Signature (by typing your full name here you are agreeing to the expectations and community agreements) *
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