BLEC PREP Youth Advisory Council (YAC)

Youth Registration & Parent/Guardian Consent Form

Youth Information

Youth Name *

County of Residence *
[radio* county-use use_label_element "Lexington" "Richland"]

Parent/Guardian Name *

PREP Program Site *

Program Description

The BLEC Youth Advisory Council (YAC) provides opportunities for youth ages 10–19 to develop leadership skills, share their perspectives, and participate in discussions and educational activities related to:

• Healthy Relationships | Contraception | Adolescent Development

• Financial Literacy | Career Readiness | Leadership Development

YAC members will participate in regular meetings, activities, and community engagement opportunities.

Parent/Guardian Consent

I give permission for my child to participate in the BLEC Youth Advisory Council and related PREP educational activities. I understand that participation is voluntary and that attendance and participation information may be collected for program reporting purposes.

Parent/Guardian Signature *

Date *

Youth Agreement

I agree to participate respectfully in YAC meetings and activities and contribute my ideas and opinions in a positive manner.

Youth Signature *

Date *

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