AYOA Leaders | American Youth Opportunity Alliance

Required for participation

AYOA Family Membership — $149 Annually

One annual membership covers a parent or legal guardian and eligible children living in the same household. Additional program fees may apply depending on the selected activity.

Read the AYOA Membership Fee & Funds Use Policy

I understand and agree to the $149 annual family membership fee, the Membership Fee & Funds Use Policy, and any separately disclosed program fees.

01 Program selectionProgram

Preferred session or start dateHow did you hear about AYOA?

02 First student

Student first nameStudent last name

Date of birthGrade

School nameSchool district

Student email (optional)

03 Additional children (optional)

Use this section to register up to two additional children from the same household.

Second student

First nameLast name

Date of birthGrade

School nameProgram (if different)

Third student

First nameLast name

Date of birthGrade

School nameProgram (if different)

04 Parent or guardian

First nameLast name

Relationship to studentPhone

EmailHome address

CityStateZIP code

05 Emergency & medical

Emergency contact nameRelationship

Emergency phoneSecondary phone (optional)

Allergies, medications, medical conditions, dietary needs, or accommodationsStudent physician and phone (optional)

06 Student goals & supportWhy are you enrolling your child or children?Student strengths and interestsBehavioral, academic, family, legal, or attendance concerns we should understand (confidential)What would a successful program experience look like?

07 Permissions & consent

I give permission for my child or children to participate in the selected AYOA program and its supervised activities.I authorize AYOA to contact emergency services and obtain necessary care if I cannot be reached.I confirm that the information submitted is accurate and complete to the best of my knowledge.I agree to receive program-related calls, texts, and emails from AYOA.I grant permission for appropriate program photos or video of my child or children to be used in AYOA communications. This permission is optional.

08 Electronic signatures

Typing names below confirms the parent/guardian’s consent and each student’s commitment to participate respectfully.

Parent/guardian full legal nameDate

Student signature name(s)Date

Your registration is sent directly to the AYOA team. Submission does not guarantee placement; we will contact you to confirm availability and next steps.

Start the journey.

AYOA Family Membership — $149 Annually

Second student

Third student