Healthy Choices Caring Communities

👤 About You

Let's start with the basics. All starred fields are required.

First name *

Last name *

Home address *

City *

Zip code *

Email *

Phone number *

Do you text? *

Yes No

Parent/Guardian name *

Parent/Guardian phone *

School you attend *

Grade for 2026-27 *

This will be my... *

General member commitment *

We get it — life is busy! Between school, sports, jobs, and family, we know it can be a lot. We ask that members try to make it to at least half of our monthly meetings and activities and stay connected on the BAND app. Meetings are scheduled based on group availability — we figure out the best day and time together! Oh, and food and refreshments are provided at every meeting 🍕 — check BAND for the RSVP reminder (usually 1–2 weeks before) to see what's on the menu. If something comes up, just give us a heads up — that's all we ask! 🙌

Yes, I'll do my best to meet this! I have some concerns — I'd like to discuss Staff will reach out to chat with you

⭐ YAC Leadership Board

Leadership Board members step up to help plan and lead YAC — it's how YOU help make the whole year happen. Are you interested?

Leadership Board interest *

Yes — I'm interested in learning more and/or joining Leadership Board for 2026-27 No — not at this time

📋 Leadership Board — What It's All About

Being on the Leadership Board is the heart of YAC — you'll help shape the whole year for everyone. Here's what's involved:

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Jump in for 2-3 pre-season planning sessions before orientation to help design the year

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Show up for most meetings & activities — your presence shapes the whole group

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A quick 30-min planning chat before or after each general meeting — snacks included! 🍿

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You pick the refreshments for each meeting — announced on BAND with the RSVP reminder 1–2 weeks out

It's more of a commitment — but it's also where the most fun and growth happens. You'll build real leadership skills, help create programs that actually matter to your peers, and have a direct hand in shaping YAC's direction. If life throws you a curveball, just communicate with us and we'll work through it together. 💪

Are you in? *

Yes, I'm in — let's do this! 🔥 I'm interested but have some questions first Staff will reach out to chat with you I'd prefer to start as a general member for now

🌟 New Member Info

Welcome to YAC! A couple quick things for new members.

Do you know any current or past YAC members?

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Join our BAND group now!BAND is where we share updates, post the menu, and keep in touch. Join while you're here!

Join BAND →

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Sign up for Remind alerts!Get quick text notifications for meetings and events — right to your phone.

Join Remind →

✍️ Final Sign-Off

Almost done! Fill in a few more details, then sign at the bottom.

Birthdate *

T-shirt size *

What do you hope to gain from being a member of YAC? *

When are you most available to meet? *

We schedule meetings based on what works best for the group — check all the times that generally work for you. We're looking at a 5–7 PM window on weekdays.

	5:00 PM	5:30 PM	6:00 PM	6:30 PM	7:00 PM
Monday
Tuesday
Wednesday
Thursday
Friday

I can also meet on weekends (Saturday or Sunday)

Drug-free commitment *

YAC is a substance-free space — and that's a good thing! 🌿 As a YAC member, you represent this program at school, in the community, and online. We just ask that your actions — in person and on social media — don't promote or support the use of tobacco, alcohol, marijuana, other illegal substances, or misuse of medications. We want everyone to feel safe, supported, and celebrated here.

First Violation: YAC adult allies discuss the potential violation privately. If on social media, member is asked to remove it. Parent/guardian notified; referred to support services.

Second Violation: Same as first, plus suspended from all in-person YAC activities for 1 month. Parent/guardian notified; referred to support services.

Third Violation: Member asked if they can meet expectations. If yes, re-signs and is suspended 1 month. Parent/guardian notified; referred to support services.

Fourth Violation: Reviewed by coalition staff. Consequences case by case, up to permanent removal. Parent/guardian notified; referred to support services.

Yes, I'm on board with this! ✅ I have questions or concerns — I'd like to talk Staff will reach out to discuss

Electronic signature agreement *

By signing below, I confirm that my electronic signature is the legal equivalent of my handwritten signature and I consent to be legally bound to this agreement.

I agree I do NOT agree

No problem at all! A paper copy will be mailed to you for a physical signature. Make sure your home address above is correct! 📬

Type your full name to sign *

Signature

Today's date *

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Not on BAND yet?Join our group to stay in the loop on meetings, menus, and all things YAC!

Join BAND →

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Not on Remind yet?Sign up for text alerts so you never miss a meeting or event!

Join Remind →

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You're officially applied!

Thanks for completing your 2026-27 YAC membership application. We are SO pumped you want to be part of this!

If you haven't already, join our BAND group and sign up for Remind so you never miss a thing:

Join BAND 📱 Join Remind 🔔

Questions? Contact Robin & Beth:
📞 419-337-0915 | ✉️ [email protected]

Join YAC! 🙌

You're officially applied!