Youth Partnership Locations Atlantic County Youth Partnership
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- Youth Partnership Locations Atlantic County Youth Partnership ACFSO
- Cape May County Youth Partnership Family Success Center
- Youth Partnership Mission Statement
- JOIN TODAY! Atlantic Cape May County Youth Group Atlantic County Meetings 2nd and 4 th Wednesday
- Youth Partnership Organization Waiver, Release and Indemnity Agreement January 1, 2017– December 31, 2017
- I give permission for pictures
- Other parent’s information if resides at different address: Can we contact Yes or No
- I have read all the by laws and agreed to follow: Signature of youth: ________________________________________________
- *PLEASE SEND A COPY OF CURRENT INSURANCE CARD, INSURED PERSON’S NAME AND DATE OF BIRTH CONTACT NUMBER
| Atlantic Cape Family Support Organization’s
Youth Partnership 
Youth Partnership Locations Atlantic County Youth Partnership ACFSO 950 Tilton Road, Unit #102 Northfield, NJ, 08225
Youth Coach, Randy Price (609) 485-0575*111 – (609) 481-9565
(609) 485-0575*103 – (609) 992-6301 Youth Coach Sharon Winter (609) 485-0575*110- (609)992-7040 Cape May County Youth Partnership Family Success Center 1046 B Route 47 Rio Grande, NJ, 08242 Youth Coach, Peggy Fuller (609) 485-0575*113 – (609) 992-6433 Standard of Conduct We will behave in an appropriate manner, which discourages arguing. We will refrain for the use of profanity. We will be respectful. We will wear appropriate clothing (girls will dress appropriately-no mini skirts, no cleavage, boys will wear no doo rags, no over size jeans-passing your bottom). We will not indulge in the use of cigarettes, drugs, and/or alcohol while at a meeting or outing. If you are 19 years old and you smoke, you must be at least 25 feet away from the youth. We will not leave a meeting without permission. Membership Requirements Be a youth between the ages of 13-21. Be a youth who voluntarily and sincerely want to join this group, so that you can do positive things in the community. Be a youth who want to advocate, educate, and reduce stigma for yourself and other youths that have emotional and behavioral challenges. Be a youth who respects the Youth Partnership Coaches and each other all the times. Be a youth who attends at least one meeting a month. The Youth Partnership should be deemed a privilege with participation and attendance to be the focus of being an “active member”. Youth Partnership Mission Statement Our goal is to be an accepted, productive member of our community. We would like to change the way the community views youth with emotional, mental and behavioral challenges. We feel we can do this through educating ourselves, our peers, and the community about these challenges that some youth face every day of their lives. We would like to turn the negative images into positive ones trough community involvement. We feel that we can be positive, productive member of our community through volunteering and education. Bylaws Membership: Membership is granted to any between the ages 13-21 in the Atlantic and Cape May County area that is presently and/or has had past experiences within the mental health system. Membership is deemed as a privilege with participation and attendance being the focus of the “active member”. An active member is one who attends meetings on a consistent basis, participates in community outreach, and is involved in other activities organized by the Youth Partnership. In addition, their willingness to be involved with our mission is voluntary and sincere. Board Membership: To be considered for one of the six seats of the Youth Partnership Board one must be an active member of at least ninety days. Youth will be selected from each group selected by their peers. Board meetings will be held quarterly or more frequently if required. There is no office positions held, such as President, Vice President, etc. Board Members will be considered for conference attendance, and will participate in the development of policies with the Youth Partnership. Board Membership is a voluntary privilege that can not exceed more than two years. Board Members must abide by the Conduct Codes at all times. Schedule Meetings: Board and committee members are required to attend all scheduled meetings. No side conversations are allowed once the meeting is started. Agenda items should be discussed before other issues are raised. All members must respect the process of the meetings. Excuse yourself appropriately. Leaving the meeting without notice is not permitted. Conduct Code: Confidentiality if our first priority. Discussions are not to be held about personal and confidential matters without written consent. There is no taunting, teasing, or intimidation allowed. Respect among members is a must. Physical contact is not permitted. Smoking and/or drug usage are not allowed at Youth Partnership meetings and sponsored events. Supervision: Supervision is minimal at meetings, conference, and planned events. The Youth Partnership is not a babysitting service. The Youth Coach, Facilitators and participating members are not responsible for those who choose to leave meetings, planned events, and/or activities unannounced. If a member does leave any event without permission will be asked to return to the group with a parent or mentor. Regular group privileges can be earned back Transportation: Transportation to weekly meetings is the responsibility of members. Unless carpool arrangements are made previously with other youth traveling to meeting, it is the responsibility of participating youth, case manager, parents, caregiver, or mentor to make transportation arrangements. 
Youth Partnership is an advocacy organization formed for and run by, youth with mental, emotional, and behavioral challenges. Membership is on a voluntary basis and youth must be between the ages of 13-21. Youth Partnership was formed to convey the following messages…. We want people to know that we are good youth. We want people to understand why we sometimes act the way that we do (but we are not making excuses for our behavior). We want other youth struggling with mental, emotional and behavioral challenges to know that they are not alone. We support each other in our struggles. We help to educate each other and other youth about mental health as it relates to our behavioral challenges. We volunteer at community events and activities. We participate in social activities that help us to learn appropriate behavior and build our self esteem. We want to be positive, contributing members of our families and the community. We attend local, state and national conferences and leadership building retreats. JOIN TODAY! Atlantic & Cape May County Youth Group Atlantic County Meetings 2nd and 4th Wednesday from 6-8pm Atlantic Cape Family Support Organization 950 Tilton Rd. Suite 102, Northfield, NJ, 08225
1046 B Route 47, Rio Grande, NJ 08242
You must attend one meeting a month to qualify for the special events, such as movies, skating, paintball, among other activities. Youth are also required to complete community service four times a year. Community service could be done individually or with the group. If you can not attend a meeting due to work or sports, just let a facilitator know, we will understand. Peggy Fuller (609) 992-6433 Kim Melton (609) 992-6301 Randy Price (609) 481-9565
any/all Atlantic Cape Family Support Organization Youth Partnership events, and intending to be legally bound, I/we agree that:
events. I/we understand that all traveling arrangements, meals and accommodations will be funded through the Youth Partnership of the Atlantic Cape Family Support Organization. Additional expenditures will be my/our responsibility.
I/we understand that it is the responsibility of the participant to take any prescribed medications as scheduled and that the Youth Partnership of the Atlantic Cape Family Support Organization and any of its affiliates, and their agents, employees, officers and directors will not be responsible or liable for dispensing any medications or for the failure of the participant to take medications or any medical complications associated with the nonuse of such medications. In the event that emergency medical care is necessary, I/we agree the Youth Partnership of the Atlantic Cape Family Support Organization may make arrangements to transport the participant to the nearest medical facility to provide such emergency care as may be needed. I/we understand that we shall be responsible for the cost of any such care. I/we understand that, if there are extreme behavioral problems that are deemed unmanageable in the sole discretion of the Youth Partnership of the Atlantic Cape Family Support Organization or any employee or agent of the Youth Partnership of the Atlantic Cape Family Support Organization it shall be my/our responsibility to pick up the participant at the event. The expenses associated with such transportation arrangements shall be my/our responsibility. I/we hereby assume any risk of personal or bodily injury, including death and damage to property. I/we waive and release the Youth Partnership of the Atlantic Cape Family Support Organization from any claim for injury or damage to me/us or the participant and agree to indemnify and hold the Youth Partnership of the Atlantic Cape Family Support Organization harmless from any claim, damage, liability or cost, including attorney fees, arising directly or indirectly in connection with the event. I/we make the agreement of this document on behalf of myself/ourselves, our personal representatives, heirs, executors and assigns. I/we have read and voluntarily signed this waiver, Release and Indemnity Agreement and agree that no oral representations, statements or inducement apart from the foregoing written Agreement has been made. Yes, ______ I give permission for pictures to be taken of my child. No, _____ I don’t want any pictures of my child to be taken. Parent’s signature: __________________________________________ Date: __________________ Youth Signature: ___________________________________________ Date: ___________________ Parents Information:
Youth Information
Other parent’s information if resides at different address: Can we contact? Yes or No
I have read all the by laws and agreed to follow: Signature of youth: ________________________________________________ Signature of facilitator: _____________________________________________ Date: _______________________  Emergency Procedure
Name of parent/caregiver: _________________________________________________________ Address: _______________________________________________________________________ Phone: ________________________________________ Cell phone: ______________________ Name of youth: __________________________________________________________________ Address/phone number (house & cell) if different form parent/caregiver: Allergies: _____________________________ Medication: ______________________________________________ [Children are responsible for taking own medications, in the correct dosage & proper time.] Reason for medication: ______________________________________________________ Emergency contact: Name: Address: Phone numbers:
List any concerns we should be made aware of: *PLEASE SEND A COPY OF CURRENT INSURANCE CARD, INSURED PERSON’S NAME AND DATE OF BIRTH & CONTACT NUMBER Signature of parent/caregiver: __________________________________ Date: ______________
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