One-In-Teen Youth Services
Youth Member Agreement
I acknowledge and agree that:
I understand that membership and attendance of One-In-Teen meetings is limited to persons
between the ages of 13 and 22 who are lesbian, gay, bisexual, transgenderal, or unsure of
their sexual orientation.
I understand that other persons must request permission to attend meetings in advance.
I will arrive on time for One-In-Teen meetings that begin at 6:30. If I need to be late, I
will come in quietly. I will wait until the smoke break at approximately 7:30 to depart,
if I am required to leave before the group meeting ends at 8:30.
I understand that attendance at One-In-Teen meetings is confidential and I will not
disclose the identity of any member or person attending One-In-Teen meetings without that
person's prior permission.
I understand that discussions during One-In-Teen meetings are confidential and I will not
discuss the specific content of any meeting.
I will help create a supportive atmosphere where members will feel safe and comfortable to
attend.
I will not participate in One-In-Teen sponsored events or come onto the Community Center
property while under the influence of
alcohol or drugs.
I understand that I am expected to show respect to other members by not interrupting them
with comments and side discussions when they are speaking. Similarly, I expect others to
show me the same courtesy when I am speaking. To show my respect for the other members, I
will maintain honest communications while participating in One-In-Teen activities.
I understand that One-In-Teen has a grievance procedure to assist in the resolution of
conflicts. If I have a problem with a group member or sponsor which I cannot personally
resolve, I have the right to have a sponsor assist me in the grievance procedure.
I understand that One-In-Teen does not endorse attendance at bars by those under the legal
age. I will not discuss attending a bar unless it is specifically relevant to issues that
I need to share with the group.
I understand that I will not be able to date One-In-Teen sponsors or adult volunteers.
I will not engage in aggressive or offensive flirting at One-In-Teen sponsored events.
I understand that I may be asked not to return to One-In-Teen activities, if I do not keep
this agreement.
I have read, understand and will abide by this agreement.
___________________________________
Signature
Name: __________________________________________ Date of Birth: _______________ Age:
_______
Emergency Name & Phone Number: ______________________________________________________
As a sponsor and a representative of One-In-Teen Youth Services, I have discussed this
agreement form with the person who has signed above and agree to keep this information
confidential.
___________________________________
Sponsor Signature