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MEIRS Youth Programs Registration Form

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Welcome to the Maine Immigrant & Refugee Services (MEIRS) Youth Programs!
Our programs are designed to provide safe and engaging opportunities for young people to learn, grow, and connect with their community.

By completing this form, you are helping us better understand each youth participant’s needs and interests so we can offer the most supportive environment possible. All information shared will be kept confidential and used solely for program planning and communication purposes.
Youth Information




















Interested Program

Parent / Guardian Information





Emergency Contact




Medical Information


Consent Review and Signature

PLEASE READ

By signing below, I acknowledge that the program in which I or my child is participating has been explained to me in a language that I understand. I understand the information below, and I agree that I and/or my child will follow all MEIRS program expectations, rules, and guidelines.

I understand that participation in MEIRS programs and activities may involve physical activity and inherent risks, including serious injury, illness, death, or loss of property. In consideration of my participation, or the participation of the above-named child (minor), I voluntarily assume all risks associated with participation in MEIRS programs and activities.

I hereby release, waive, discharge, and hold harmless MEIRS, its employees, volunteers, affiliated organizations, sponsors, associated personnel, and the owners of facilities used for program activities from any and all claims, liabilities, damages, or causes of action arising out of participation in MEIRS programs and activities, including claims resulting from ordinary negligence. 

I further agree to indemnify and hold harmless MEIRS and all related parties from any claims arising from my or the above-named child’s participation in, or receipt of instruction through, MEIRS programs and activities.

I affirm that I am the participant, parent, or legal guardian of the above-named child (minor), and that I am freely and voluntarily signing this agreement. I have carefully read and fully understand this form, and I acknowledge that by signing it, I may be waiving certain legal rights and remedies otherwise available to me.

I also agree that the participant(s) will abide by all MEIRS rules and policies.

I give permission for myself/my child to participate in field trips, recreational activities, and program activities both inside and outside of MEIRS facilities. I further authorize my child to be transported by a MEIRS vehicle or by a MEIRS staff member’s vehicle as needed for program activities, field trips, services, or emergencies.

By signing this consent, I also authorize MEIRS to use photographs and/or video images of myself or my child for promotional purposes, including but not limited to newspapers, advertisements, displays, social media, and the MEIRS website.

PROGRAMS EXPECTATIONS

MEIRS is committed to providing a safe, inclusive, and enriching environment for all youth and participants. To ensure the success of our programs and the well-being of everyone involved, all youth and participants are expected to follow these guidelines:

Respect for Staff, Volunteers, and Peers

  • Follow all instructions and guidance provided by staff and volunteers.

  • Show respect in words and actions toward others at all times.

Behavior Standards

  • Physical aggression, including fighting or threatening others, is strictly prohibited.

  • The use of foul, abusive, or discriminatory language is not allowed.

  • Unsafe behaviors—such as bullying, harassment, or property destruction—will not be tolerated.

Attendance and Participation

  • Regular attendance and active participation in program activities are encouraged and expected.

  • If you are unable to attend, please inform program staff in advance.

Substance-Free Environment

  • The use or possession of drugs, alcohol, tobacco, or vaping products during program time is strictly forbidden.

Appropriate Use of Technology

  • Use of phones, tablets, and other devices should be limited to approved activities.

  • Cyberbullying or sharing inappropriate content will result in disciplinary action.

Dress Code

  • Wear appropriate attire that promotes comfort and respect for the diverse backgrounds of participants.

Property Respect

  • Respect MEIRS property and the property of others. Vandalism, theft, or intentional damage will result in consequences.

Consequences for Policy Violations

MEIRS reserves the right to suspend or remove any youth or participant from the program if they violate program or agency guidelines.

  • Suspension decisions will be made in the interest of safety and fairness and may involve parents/guardians where applicable.


Maine Immigrant & Refugee Services | 256 Bartlett Street | Lewiston, ME 04240