2024 Social Groups - November Teen Scene

November Teen Scene: Friendsgiving with the Teen Scene and Adult Hangout!

Registration open through November 13th, or until at capacity

Teen Scene is a social group geared toward high schoolers. Events are planned by our Teen Board of Directors. This November, we're hosting a Friendsgiving potluck meal in collaboration with our adult social group, the Adult Hangout!

Get excited for a Teen Scene and Adult Hangout mashup! Celebrate the season of gratitude by sharing a potluck meal with your Jacob's Chance friends. Join us for food, crafts, and friendship!

After registering, please sign up to bring a dish HERE!

Date: Sunday, November 17th

Time: 3:30-5:00pm

Location: St. Michael Catholic Church - Lake House (4491 Springfield Rd, Glen Allen, VA 23060)

Cost: $5

Ages: 13 through high school

Amount *	Quantity
$5 - Participation fee
$0 - Full Financial Assistance

Refund Policy *

Jacob's Chance is able to process refunds upon request, up to one week prior to the start of the program/session, minus a 10% processing fee. We will not process refunds for fees below $10.

I acknowledge and accept the terms of the refund policy.

Optional Donation - Support the Mission!

$100

$50

$25

$10

Family Contact Information

Parent/Guardian Name *

First Name

Last Name

Email *

Verify Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Participant Information

Name *

First Name

Last Name

Birthdate *

(mm/dd/yyyy)

Participant Diagnosis *

Any accommodations requested/helpful tidbits? *

Is there anything we should know about the participant to ensure they have the most success possible? *IMPORTANT* - Per our policies, "we are unable to provide assistance with the following: toileting, wheelchair transfers, feeding, and any other ADLs." If your participant requires this type of assistance, a parent/guardian/caregiver must stay onsite the duration of the program. If you have any questions, please feel free to give us a call!

Does the participant have any allergies? (dietary or outdoor) *

Jacob's Chance will not administer any medication, so any rescue medication must be brought and administered by guardian/participant

Demographic Data *

Data collection is used only for grant compliance and internal review purposes. Check all that apply

Caucasian

Black or African American

Asian

Indigenous American or Native American

Native Hawaiian or Pacific Islander

Hispanic or Latino

Not of Hispanic Origin

Not interested in reporting

Gender Identity *

Data collection is used only for grant compliance and internal review purposes. Check all that apply

Male

Female

Non-binary

Other

Not interested in reporting

Requested pronouns (examples: he/him, they/them, she/her)

Policy Agreements/Waivers

Jacob’s Chance requires all participants, family members, caregivers, staff, board members, and volunteers to conduct themselves in a safe and respectful manner to help maintain a comfortable, safe, and fun environment. In order to engage in Jacob's Chance programs, everyone must read thoroughly and agree to the terms established by the documents below.

Jacob's Chance Code of Conduct

Jacob's Chance Program Policies

Jacob's Chance Risk, Media, & Concussion Waivers

I have read fully, and agree to the terms established by the waivers/policies linked above. *

Yes

Name of the person responding to the above waivers/policies, on behalf of the participant registered. *

First Name

Last Name

Add 3% to my total amount to help cover the payment processing fees