ARCC's Virtual You Groups & Events
Sign up for Alum Rock Counseling Center's Virtual You Groups and Events from January to May! Below is a brief description and schedule for each group. All groups are specific for youth and young people ages 12-25.

MINDFUL MONDAYS

This group is for youth and young people looking to wind down, re-center, and find self-care in community. Each week will focus on a different theme and consist of a guided meditation, activity, discussion, and breath-work. Weekly themes include Grounding, Gratitude, Acceptance- Commitment, Self-Love, and more!
Middle School: Mondays, 3:15-3:45pm | High School & College: Mondays, 4:00-4:30pm

COLOR & VIBE

In this group, you will learn how to implement self care into your daily lives while also vibing to music and making art. Sessions include creating color wheels, doing coloring sheets together, and how-to drawing tutorials!
All ages (12-25 years old): Tuesdays, 5:00-6:00pm

GAME NIGHT

In this group, we will be playing popular games such as among us, Jack box, house party games, and more! This group is open to anyone who wants to come have some fun and be in community!
Middle School: Wednesdays, 4:30-5:30pm | Game Night After Dark (High School & College): Wednesdays, 5:45-6:45pm

TALK SPACE

In this group, we'll be hosting a space to simply vent about some of the things that have been hard this year. Each week will be a themed topic such as "how hard zoom school is," to "missing our normal social events" and more. We'll support one another while we take some time to let it all out. *please note, this is not a therapy group, but we can provide therapy referrals as needed.
Middle School: Every 1st and 3rd Thursday of the month, 4:30-5:30pm | High School & College: Every 2nd and 4th Thursday of the month, 4:30-5:30pm

SHOW & TELL

In this group, we will host a virtual show and tell! You will have the chance to show off maybe some pets, a cool gadget, a weird talent, or whatever you think everyone should know about while building community and having fun! Everyone is welcome even if you don't want to share.
Middle School: Fridays, 5-6pm | High School & College: Fridays, 6:30-7:30pm

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Groups will take place on an ARCC Zoom account monitored and facilitated by ARCC staff. Zoom link will be sent out after registering. All groups are drop-in and welcome to everyone!

For more information, contact:

Celina Chun, Director, cchun@alumrockcc.org, 408-910-0446

Janae Stewart, Team Lead, jstewart@alumrockcc.org
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Participant Information
Participant full name *
Phone # of participant (This would be for reminders, Zoom link, etc.) *
Email of participant (Note: we are unable to contact school student email accounts due to school safety precautions) *
Additional participant email (optional)
Please select which Virtual You group(s) you'd like to attend. *
Required
If you signed up for Color & Vibe: please check all of the supplies that you have. *
Required
If you signed up for Color & Vibe: I am able to pick up materials from Alum Rock Counseling Center at 777 N 1st Street, San Jose, CA 95112. *
If you signed up for Color & Vibe: If you are not able to pick up materials, please write the full address of the location that you would like the materials to be dropped off.
What is your age? *
What is your race? (check all that apply) *
Required
If you identify as Hispanic or Latino, what is your ethnicity? (check all that apply)
If you identify as Non-Hispanic or Non-Latino, what is your ethnicity? (check all that apply)
Do you identify as more than one ethnicity? *
What is your primary language? *
What was your gender assigned at birth? *
What is your current gender identity? *
How would you describe your sexual orientation? *
Do you consider yourself to have a disability? A Disability is defined as a physical or mental impairment or medical condition lasting at least six months that substantially limits a major life activity, which is not the result of a severe mental illness. *
If yes, how would you describe your disability? (check all that apply)
Participant's 5-digit zip-code *
How did you find out about Virtual You? *
Consent for Participation (must be completed by a parent/guardian if under 18 years old)
In order to participate, we must have a parent/guardian’s permission if participant is under 18 years of age. The parent/guardian must read the following and e-sign their name below. If the participant is over 18, they may sign for themselves.

In consideration of being permitted to participate in any way in the Virtual You Alum Rock Counseling Center groups from January 19, 2021 to May 28, 2021 on Zoom, herein after called “The Activity,” I/We, the undersigned, being the parent(s) or legal guardian(s) of the youth participating, do hereby grant permission for his/her participation in The Activity provided by Alum Rock Counseling Center (ARCC) and release ARCC and their agents from all causes of legal action, damages, and claims or inequity of any kind whatsoever from any illness injury or loss resulting from participation in ARCC, programs or activities and for ARCC to maintain records of the participation. Our record keeping system is designed to protect your personal rights and ensure privacy. However, there are a limited number of individuals who will have access to your records including other providers or professionals involved in the program providing The Activity, as well as the program funder. Additionally, group data results may be published in reports and journals. I/We also hereby give consent and release, without recompense, for the use of photographs, recordings or videotape, which may include my child, taken for the purpose of ARCC publicity, publications, promotions, or news media coverage of ARCC activities. I also hereby agree that I/we and my child will abide by the safe orderly and effective operation of ARCC programs and activities, and understand that failure to so abide may result in termination of my child’s participation in ARCC programs or activities at the sole discretion of ARCC or its agents.

I understand that The Activity is not a mental health treatment program or psychotherapy services, and that those facilitating The Activity are not necessarily mental health treatment professionals.

Acknowledgement of Mandated Reporter:

Any administrator or employee of an organization, who in good faith has a reasonable suspicion of an act of child abuse, whose duties require direct contact and supervision of children (California Penal Code section 11165.7, California Welfare & Institutions Code 15610.17) are required to report child abuse to Children’s Protective Services or local law enforcement. This includes all ARCC staff, providers, and contractors.

By signing below, I agree that I have fully read and accept the terms in the release and consent.
I have fully read and accept the terms in the release and consent *
Are you signing as a parent or guardian? *
Are you over the age of 18? *
Please sign your full name below to complete the consent. *
Date of signature *
MM
/
DD
/
YYYY
Phone # and/or email address of parent/guardian *
(this is required for participants under the age of 18)
Can staff communicate with the parent/guardian through text messages? *
We would share the Zoom link, feedback survey, remind about groups and other updates.
Can staff communicate with the parent/guardian through email? *
We would share the Zoom link, feedback survey, remind about groups and other updates.
How do you prefer the Zoom link to be provided to you? *
Required
Please confirm the email(s) you'd like the Zoom link sent to. We are unable to contact middle school email addresses. *
(If you do not want us to email you, enter N/A)
Please confirm the phone number(s) you'd like the Zoom link sent to. *
(If you do not want us to text you, enter N/A)
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