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UW Native Youth Mentorship Day
July 14th 10 AM - 4PM

Registration Form

Native Middle School and High School students earn $300* for full participation.

The day incorporates experiential learning activities and mentoring with UW students, educators, and staff, tours, food, class learning, resources and support services.

*(Payment requires W9 and invoice, please allow 5-10 days for processing)

Student First name

Student Last name

Pronouns

Birthday

Age

Grade

School Name

Tribe/s

What interests you most about this event and why? What do you hope to gain? 50 words

Do you agree to cooperate, participate, & complete the final presentation and survey? (Presentation will be to share “What did you learn that was interesting? What do you want to revisit or learn more about?”).

HEALTH/BEHAVIORAL CONSIDERATIONS, (INCLUDING MEDICATIONS), DISABILITIES

Parent/Gaurdian First name

Parent/Gaurdian Last name

Phone

Street Address

City

Region/State/Province

Postal / Zip code

Clear Sky Participation Policy

Youth at Clear Sky events and activities are expected to behave in a positive and respectful manner to other youth, elders, adults, and community volunteers. Cooperation and teamwork are central to our interactions among ourselves, and with other organizations and teams. Students who are not able to meet this expectation will receive a brief time out. In the case of repeated misbehavior in a single day, parents/guardians may be asked to take the student home for the day.

PARENTAL RELEASE, PLEASE MARK ALL THE OPTIONS.

I approve my child’s participation with the UW Mentorship Day and certify that they is in good health.

I hereby release UNEA of all liability. I accept responsibility for any injury or medical expense incurred by my child during the UW Mentorship Day program.

I have read and accept the Clear Sky Participation Policy (above).

I also approve of photos/pictures/video taken of my child for promoting UNEA purposes only.

Contact Us

P.O. Box 25142 Seattle, WA 98165

uneachair@gmail.com | Tel: 206-941-0338

Please send us a message; we will get back to you shortly.