Youth Advisory Council Application

Legacy Driven Foundation, Inc. is looking for motivated high school students to share ideas, collaborate with peers, and help shape decisions that impact youth in the community. Thank you for your interest in joining our Youth Advisory Council (YAC)! We're excited to learn more about you and your passion for making a difference.

This initiative is for H.S. students that fall within the criteria listed below:

Enrolled in grades 9th-12th (Ages 14-18)
Maintain 2.75+ GPA
Attend monthly or bi-monthly virtual or in-person meetings
Reside in Gwinnett, Dekalb, Cobb, Walton and/or Fulton Counties

Upon completion of your application, a member of our team will review your submission and reach out to you with next steps.

If you have any questions, please email us at yac@legacydriven.org and we will respond within 24-36 hours.

YAC Team - Taylor May, Maria Wells and Kim Curney

YOUTH SECTION:

Name

First Name

Middle Name

Last Name

Phone

Preferred Contact Method

Call

Birth Date

Current Age?

Current Grade?

What High School do you attend?

Which county is your school located?

What is your cumulative GPA (Grade Point Average)?

What’s the reason you’re interested in joining the Youth Advisory Council?

What does being a youth leader mean to you?

What changes or improvements would you like to see in your community, state or country?

What skills, strengths or qualities do you bring to the Youth Advisory Council?

What is one issue affecting youth today that you are passionate about?

What is one creative idea you would propose to improve your community?

What’s the reason we should choose you?

Are you available to attend monthly meetings (Virtual and/or In-person) and participate in LDF events throughout the year?

Allergy/Medication Information:

PARENT SECTION:

Parent/Guardian Name:

First Name

Last Name

Phone

What's the best time to reach you?

Parent/Guardian Waivers/Releases (All waiver options must be checked before submitting this application)

Parent/Guardian, the SIGNER of this REGISTRATION FORM which includes immediate & extended family, “Releases” Legacy Driven Foundation Inc., Any/All schools within in the State of Georgia, other participants, officers, directors, agents, other staff from any/all liability for said YOUTH(s) registered for this initiative and all other’s under the organization of Legacy Driven Foundation, Inc..‎

It is the purpose of this agreement to exempt, waive and relieve “Releases” from any and all liability for personal injury including re-injury from a past injury, property damage, wrongful death, including if caused by negligence, including the negligence, if any, Releases.‎

I recognize that there are certain inherent risks associated with the activity of PHYSICAL FITNESS TRAINING, SPORTS ACTIVITIES and I assume full responsibility for personal injury to child(ren) including myself, and (if applicable) other family members if participating in inside/outdoor activities, and further release and discharge Legacy Driven Foundation, Inc and above mentioned entities, and any related/associated businesses or other third parties.‎

I give Legacy Driven Foundation, Inc. full AUDIO, PHOTO & VIDEO permission for your youth and/or adults during any Sessions to be recorded. Please note that AUDIO, PHOTO and/or VIDEO may be posted on our social media and/or website channels at any given time.‎

I give Legacy Driven Foundation, Inc. full access to my child(ren) school related data including but, not limited to PBIS (Positive Behavioral Interventions and Supports), academic, behavioral and attendance records for qualitative & quantitative purposes to better understand and serve my student(s).‎ (Note: This data will not be shared outside of Legacy Driven Fdn.)

I, THE PARENT AND/OR GAURDIAN OF THIS APPLICANT, HAVE READ THIS DOCUMENT AND UNDERSTAND IT FULLY. I FURTHER UNDERSTAND THAT BY SIGNING THIS RELEASE, I VOLUNTARILY SURRENDER CERTAIN LEGAL RIGHTS.‎

Yes

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Youth Advisory Council Application

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