Registration: Rites of Passage Adventure Weekend

Rites of Passage Adventure Weekend Registration

We will invite participants, mentors, and Jmen to attend the weekend based on a first come, first serve basis.

Questions? Jordan@journeymentriangle.org | 919.907.1177

Who are you registering?

Participant: a young man participating in his first ROPAW // Friday arrival

Mentor: a volunteer staff member (18+ years old) // Thursday arrival

J-man: a return participant (under 18) // Thursday arrival

Who are you registering?

Participant

Mentor

J-man

Participant Information

First Name

Last Name

Email Address

Cell Phone Number

Address

Address Line 1

Address Line 2

City

State

Zip Code

Country

Parent's Information

Parent's First Name

Parent's Last Name

Parent's Email

Parent's Phone Number

Confidential Medical Questionnaire

If you or your participant become ill or injured during ROPAW you authorize us to share this information with medical personnel. Otherwise, all information will be kept strictly confidential.

Will the participant taking any medication (prescription or nonprescription) that will be required during the weekend?

Yes

No

Please List Medications, how much (mg), how often needed, and current side effects

Emergency Contact Full Name & Relationship

Emergency Contact Phone Number

Do you or your participant have health insurance?

Yes

No

Insurance Company

Policy Number

Insurance Co. Phone Number

Do you or your participant have any medical or psychological condition that would affect your participation in the weekend?

Yes

No

If yes, please explain:

In case of medical emergency please list specific instructions:

Please list food allergies and/or food sensitivities and label as such. Write "N/A" if none.

Consent Disclaimer

I consent that Journeymen may photograph and videotape parts of the upcoming weekend in order to promote future Journeymen events. By signing and returning this form I give my or my participants' consent to Journeymen (this is a voluntary request).

• I agree that participants may be interviewed, recorded and photographed by Journeymen or any person Journeymen mandates to that effect.

• I accept that Journeymen may or may not use participants name, image and likeness in any verbal presentation, conference, interview and written publication.

• I recognize that Journeymen shall have the exclusive rights to the materials indicated above, including copyrights and proprietary rights, and I assign to Journeymen any right in relation to the materials.

• Journeymen may not assign or transfer, in whole or in part, the rights granted by the present contract.

Consent

Release & Acknowledgement of Risks

Parent of Participant Commitments: (please check where appropriate)

I agree to arrive on-site by 5pm on Friday and will stay for the opening ceremony from 5-6pm with my participant.

I agree to arrive on-site by 2pm on Sunday and will participate in parent circle & re-integration from 2-3pm.

I agree to attend the Homecoming Ceremony with my son (one or two weeks after ROPAW)

My participant will complete the questionnaire at least 2 weeks before the weekend: https://forms.gle/zN8uph47YrwqVwHX6

Mentor & J-man Commitments: (please check where appropriate)

I will attend the mandatory staff meeting before the weekend (Sept 12, 6:30pm, Zoom)

I agree to arrive on-site by 4pm on Thursday

I am aware that my acceptance to participate is subject to a background check no older than 18 months and that Journeymen must run its own background checks.

I agree to attend the Homecoming Ceremony (one or two weeks after ROPAW)

I will complete the Jman Questionnaire and understand that this is used in consideration of the 10 positions available.

I have read and agree to the Terms and Conditions.

Participant Signature

Sign Here

Parent Signature

Sign Here

Payment Options

Disclaimer: Our weekends are driven by many volunteer hours AND we rely on tuition to cover costs. However, we do not want finances to be a barrier for anyone attending and will work with you to make this weekend accessible.

Additionally, we ask those who can, to pay it forward to help cover the costs of folks who may otherwise not be able to afford the full tuition. If this is you, please select "Yes" to the question about scholarships and we'll reach out to you.

Mentors & Jmen: The $150 fee covers lodging and food Thursday - Sunday as well as supplies & admin fees.

Participants: The $500 fee covers the entire ROPAW weekend experience (Friday - Sunday) for your young man. Please pay the $100 deposit to lock in your position on the weekend. After the weekend, your young man will be eligible for ongoing group mentoring sessions at no cost for at least 1 year.

*By signing above you are agreeing to these payment terms*

Payment Options:

Mentor & Jman Tuition: $150

Participant Deposit: $100

Participant Tuition: $500

Please Contact Me

Please explain your needs & availability for a payment plan. Is there an amount you could contribute that would be life-giving for you?

I'd like to support the ROPAW scholarship fund

Yes

Not now

Support the Scholarship Fund

Thank you! Please click the above link and then complete application below.

Pay with Card (Stripe)

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Registration: Rites of Passage Adventure Weekend

Rites of Passage Adventure Weekend Registration

Who are you registering?

Confidential Medical Questionnaire

Consent Disclaimer

Release & Acknowledgement of Risks

Payment Options

Get Involved

Rites of Passage