Youth with a Purpose Registration

YFC Canada

YFC is a national organization built on local chapters.

Registered Charity #106868847RR0001

YFC Northumberland

Registered Charity #132177296RR0001

Youth with a Purpose runs on Monday evenings. Registration is required (below).

For more information, please contact Connie at connie@nyfc.org.

Go to the registration form

Back to the Youth With a Purpose page

Youth with a Purpose Registration 2026

This field is hidden when viewing the form
Program Season
This field is hidden when viewing the form
Program – for iATS Comments
How many youth are you registering? (ages 10-14)*
Youth #1 Info
Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Gender*
Allergies or Medical Conditions
Other helpful information which may help your child thrive in the program
Youth #2 Info
Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Gender*
Allergies or Medical Conditions
Other helpful information that may help your child thrive in the program
Youth #3 Info
Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Gender*
Allergies or Medical Conditions
Other helpful information that may help your child thrive in the program
Home Address
Address*
Street Address Address Line 2 City Province Postal Code
Parent/Guardian Info
1st Parent/Guardian Name*
First Last
1st Parent/Guardian Cell Phone*
1st Parent/Guardian Email*
Enter Email Confirm Email
2nd Parent/Guardian Name
First Last
2nd Parent/Guardian Cell Phone
2nd Parent/Guardian Email
Enter Email Confirm Email
Consents
MEDICAL / PERSONAL HARM*
Yes
I hereby release Northumberland Youth Unlimited from responsibility and liability for any harm that may occur to the youth in my care noted above, as a result of their wilful participation in the program/activity described above. I understand that reasonable precautions for the health and safety of participants will be taken. Furthermore, I give permission for the person(s) in charge to seek medical assistance for the youth in my care noted above, in the event of accident or injury, and acknowledge that I must assume total responsibility for any and all medical assistance related costs. Every attempt will be made to contact parents or guardians before such action.
AGE 10+ PERMISSION TO SIGN IN/OUT (optional)
Yes
I give permission to the youth in my care noted above (age 10+) to sign themselves in and/or out without a parent present. In doing so, I release Northumberland Youth Unlimited of any responsibility after they sign out and leave the premises.
FAITH DISCLOSURE*
Yes
I understand that Northumberland Youth Unlimited is a faith-based charitable organization that is operated by Christian values. I understand that Northumberland Youth Unlimited is inclusive to all program participants regardless of their personal religious belief, race, sexuality, gender, or socio-economic status. I understand that the staff and volunteers of Northumberland Youth Unlimited, with the utmost dignity and respect, may engage in conversations and/or lessons regarding topics of faith with the youth in my care noted above, during the course of their participation with Northumberland Youth Unlimited.
PHOTO / VIDEO (optional)
Yes
I do authorize Northumberland Youth Unlimited to take, use and own, in perpetuity; photo/video/audio recordings of the youth in my care noted above, understanding that these may be used for public promotional purposes. NOTE: Northumberland Youth Unlimited does not sell or give away any recorded materials or mailing list information.
PARTICIPATION*
Yes
I understand that the program/activity described above is a program of Northumberland Youth Unlimited and all consents on this page also apply to this program/activity. I have read, understood and hereby give permission for the youth in my care noted above, to attend and participate fully in the program/activity described above by Northumberland Youth Unlimited and agree to these waivers and conditions.
Signature*
Fees
YWP Registration Fee #1
Price:
YWP Registration Fee #2
Price:
YWP Registration Fee #3
Price:
Payment Details
Credit Card*

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Total
$ 0.00 CAD

Youth with a Purpose Registration 2026

Youth #1 Info

Youth #2 Info

Youth #3 Info

Home Address

Parent/Guardian Info

Consents

Fees

Payment Details