University of Youth Power 2022 | Families Together in NYS

Welcome to the University of Youth Power registration! If at any time you have questions, contact Amanda Davidson at 518-949-0368 or email ADavidson@ftnys.org.

FTNYS continues to monitor and navigate the ongoing developments of the COVID-19. The health and safety of our FTNYS community are of the utmost importance and we are excited about safely gathering in Albany, NY June 24-27th.

We are abiding by and enforcing all guidelines set forth by the City of Albany and New York State. Per these guidelines, beginning on February 10, 2022 requirements for vaccine verification, proof of negative test and masks have been lifted. Therefore, FTNYS will not require vaccine verification, proof of negative tests or masks.

MASKS - Although the mask requirement in NYS has been lifted, attendees are strongly encouraged to wear masks.

UYP Registration Information

First Name: *

Last Name *

Pronoun

Such as: He/Him, She/Her, They/Them

Organization

Job Title

Date of Birth *

If you are under the age of 18 you are only eligible for the Disability Leadership Track and you will be residing with your parent/caregiver at the Staybridge Hotel.

Phone *

Email *

County

Emergency Contact Name *

Emergency Contact Phone Number *

Major *

If you selected Disability Leadership Major, will your parent(s)/caregiver(s) be attending the Parent Track (Foundations in Leadership) at the Staybridge Hotel?

Yes No

If your parent/guardian(s) are participating in Foundations for Leadership, list their full names here:

Accompanying Parent/Guardian Email

Accompanying Parent/Guardian Cell Phone

T-Shirt Size *

Will you be bringing a support person?

Yes No

A support person must register and pay for attendance. Support individuals must register at bit.ly/UYP22SP

List any disability accomodations *

Dietary Restrictions: *

Please list all allergies *

I agree to become a member of Youth Power

I agree

I hereby consent to and authorize the use of information for publication purposes to: New York State Developmental Disabilities Planning Council and Families Together in New York State. I consent to and authorize the use, publication, and reproduction of any and all photographs, digital images, videotapes or recordings made of me, and the right to copyright and/or use, reuse, modify, and/or publish, republish photographic pictures, digital images, videotapes or recording in conjunction with my name. I also give permission for the photographs, digital images, videotapes, or recordings to be used in their entirety and/or edited versions, as deemed necessary, including the use of images on agency-operated websites. Furthermore, permission is also given for the photographs, digital images, videotapes, or recordings to be used at any time in the future without further clearance from me. I have read the release and agreement. Before signing below, I authorize that I fully understand the contents above.

Photo and Video Release

I agree I disagree

Anyone under the age of 18 will be residing with their parent at the Staybridge Hotel located at 39 Wolf Rd, Albany, NY 12205. All students 18-30 will be sharing as dorm style room with a UYP peer participant.

If you would like to request a roommate, please list their name below

I have legal authority to register myself or this youth for this event and I give permission for this youth to attend UYP. If under 18, I understand that this youth must be supervised by the accompanying parent, caregiver, or chaperone. This youth agrees to abide by the rules of the conference. I understand that FTNYS and its staff are not responsible for monitoring this youth and I will not hold Families Together in NYS liable in the event of injury. I agree to the liability statement above.

Liability Statement *

Yes No

Event Fee(s)

If you have a discount code, enter it here

Event Fee(s) *

Resident Student - $ 750.00

Day Student - $ 500.00

Total

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

Learn more about the University of Youth Power (UYP) at FTNYS.org/UYP.