By clicking the box below I understand that it serves as an authorization to enroll my child in the YWCA Jamestown Young Women Choosing Action Program, and I understand that the submission of this form indicates my desire for my child to be enrolled in the program in accordance with the information that I have provided herein.
I understand that by submitting this enrollment form I am indicating my willingness to pay the associated costs for my child to attend and complete any or all paperwork as required.
I give my permission for my child to travel on foot while properly supervised by Jamestown Young Women Choosing Action. staff to nearby locations within a reasonable distance as determined by the Site Coordinator without my written permission. I understand these will be called “walking field trips” and may happen unannounced.
I give permission for my child to view videos and/or audio/visual materials deemed appropriate by program administration that are rated G, PG, and PG-13 for purposes of enrichment and/or recreation.
I understand that a violation of any YWCA Young Women Choosing Action policies on my part or on the part of my child may result in termination from the program.
I understand that all policies contained in this enrollment form are subject to change without notice
The YWCA is committed to providing equal enrichment opportunities to all children enrolled, and maintains a strict policy prohibiting unlawful discrimination. No qualified student shall, on the basis of disability, race, religion, color, sex, national origin, or ability to pay, be excluded from participation in, be denied benefits of, or otherwise be subject to discrimination under YWCA Jamestown Jamestown Young Women Choosing Action.
My signature below indicates my acceptance of the policies stated herein on this page, and will uphold those policies to the best of my abilities as a condition of my child’s enrollment in the program.
Will transportation be a barrier to attending Young Women Choosing Action?
Thank you for registering for the YWCA Jamestown's Young Women Choosing Action Program! Your commitment to joining this empowering initiative signifies a step toward not only enhancing your leadership skills but also embracing the transformative journey of female empowerment. We believe that every young woman has the potential to make a significant impact in her community and beyond, and through this program, we aim to equip you with the tools, knowledge, and confidence needed to realize that potential. As we prepare to kick off our next group, please be on the lookout for further communications regarding program details, schedules, and opportunities to engage with like-minded young women who are equally passionate about making a difference.
If you have any questions, comments, or concerns, I can be reached at jcook@ywcajamestown.com or feel free to text me at
716-241-1141!
Warm regards,
Jacqueline Cook
Program Director
YWCA Jamestown
