CODE OF CONDUCT

Carefully review the Code

of Conduct and return your

signed registration form to

the Teen Center staff.

Welcome to the Teen Center!

We are glad that you have chosen to participate in the activities and programs we have available. The Teen Center is a community center, owned and operated by the City of Woodland Park. It is open to youth in grades 6 through 12 who register at the Teen Center. Anyone younger must be accompanied by a parent or guardian. Anyone older must be a parent or guardian accompanying their child. There are lots of activities to get involved with and our Elevate Café offers low cost snacks and drinks to purchase.

Our goal is to always have a safe and enjoyable environment for you and your friends. In order to have this positive environment we must work together. Your role is to be responsible, respectful, and to relax and enjoy your Teen Center. It is a privilege to belong to the Teen Center, and as a member you are responsible for your own words and actions. Teen Center expectations for Members include:

  1. Speaking for yourself
  2. Listening to others
  3. Using Put Ups, not Put Downs
  4. Caring for others, the Teen Center property, and yourself
  5. Being honest
  6. Showing respect for all
  7. Being responsible for yourself
  8. Treating others in a way that you like to be treated
  9. Wearing appropriate clothing
  10. No Inappropriate Sexual Behavior (No Public Display of Affection)
  11. No foul language

The Teen Center has a Zero Tolerance Culture, which does not accept behaviors that are distracting, disruptive, or destructive. These are disrespectful behaviors which will be directly addressed by the Teen Center staff with consequences enforced. Consequences can include a warning, contacting parents / guardians, suspension from Teen Center programs, and law enforcement contact. Examples of these behaviors include: the possession or use of weapons, alcohol, tobacco products, or any other drugs, sexual misconduct, any other criminal behavior, harassing or bullying, using foul or hostile language, fighting, being destructive with equipment and property, wearing inappropriate clothing, and public displays of affection.

Thank you for helping to make the Woodland Park Teen Center a positive and fun place to be. We look forward to great times together!!!

Today’s Date: ______

Teen Name: ______Date of Birth: ______

Last First MI (MM/DD/YYYY)

Teen Mailing Address: ______APT # ______GRADE:______

City: ______State: _____ Zip: ______

______

Teen Home Phone Teen Cell Phone Teen E-mail

MOTHER/Guardian Name: ______

LastFirst

Mother’s Mailing Address (if DIFFERENT than yours): ______APT # ______

City: ______State: _____ Zip: ______

Phone #: ______

Home Cell Work E-mail

FATHER/Guardian Name: ______

LastFirst

Father’s Mailing Address (if DIFFERENT than yours): ______APT # ______

City: ______State: _____ Zip: ______

Phone #: ______

Home Cell Work E-mail

Emergency Contact Name: ______Relationship: ______Phone:______

Allergies or other medical conditions (such as asthma, seizures, diabetes, etc.): _____ No_____Yes

Please explain:______

Do you take any medications? _____ No _____Yes If so, please list medication/s: ______

PLEASE CONTINUE TO PAGE 2 TO COMPLETE THIS REGISTRATION FORM

SERVICE LEARNING PROGRAM OVERVIEW & GOALS:

The Service Learning Program is a way that teens can actively participate in thoughtfully organized, local service activities that meet the needs of our community. It provides structured time for youth participating in the program to reflect on their service experience, and offers opportunities for lifelong knowledge and skill development. Participants earn individual and group rewards, and recognition. YOU MAY USE THESE HOURS FOR SOME OF YOUR REQUIRED SCHOOL SERVICE HOURS. The program goals include:

  • Preparing youth to be a contributing member of the community
  • Equipping youth with skills to last a lifetime
  • Helping to bring relevance to many in-school lessons
  • Developing healthy and self supporting decision making skills

Some of the SERVICE LEARNING ACTIVITIES are listed below – Please mark all that interest you:

Recycling (Keep Woodland Park Beautiful)
Adopt a Spot (Keep Woodland Park Beautiful)
Earning Good Grades & Grade Improvement
Activities & Service with the Senior Center
Community Cupboard-Food Distribution / Life Skills Activities (cooking, communication, self confidence, relationships, etc.)
Community Events
Food Drives & Clothing Drives
Other: ______

Are you interested in a leadership position(this includesthings like coordinating volunteers, planning and coordinating events and activities with Teen Center staff)? Please circle one: Y / N

Why would you like to participate in the program? ______

List any organizations or activities you are currently involved in: ______

Which of the following needs and interests do you have? (Check all that apply):

NEEDS you & your family may have: / LEARNING INTERESTS– check all that apply
____ Clothing assistance / ____Cooking _____Beauty School ____Geocaching
____ Food assistance / ____Crime Scene Investigation ___Drama ___Animals/Animal care
____ Access to medical care / ____Fishing ____Hiking ____Horseback Riding ____Auto repair
____ Workforce assistance / ____Video Production ____Rafting ____Ropes Course ____Music
____ Other: please list / ____Skiing ____Frisbee Golf ____Indoor Skydiving ____Biking
____Golf ____Gold Mining ____Railroads ____Rockets ____Water
____Firefighting ____Gardens/Greenhouse ____Wildland/Forests
Other:

Personal Release: I understand that the Teen Center activities and services may have an element of hazard or inherent danger and I take full responsibility for my child’s actions and physical condition. I agree to indemnify and hold harmless the City of Woodland Park and its employees from any liability loss, cost, or expense (including attorney’s fees, medical and ambulance cost) that may be incurred while participating in activities. I give consent to use photographs taken of my childduring Teen Center activities for future promotional activities, and have reviewed the Teen Center Rules & Code of Conduct with my child.

My teen has permission to play M-rated video games.______No ______Yes

Parent/Guardian ______Date______

Signature Printed Name

I have reviewed the Teen Center Rules & Code of Conduct and agree to abide by them.

Teen Center Participant ______Date______

Signature Printed Name