1 Start 2 Complete Join the #YouthInCareAreAwesome Campaign for BC Child and Youth in Care Week 2023! Open to children and youth in and from government care in BC up to age 24. Gift card honorariums of up to $50! Check out the amazing submissions from youth from last year's campaign! Please complete this submission form by May 2, 2023. Be sure you have all the information ready to enter before you begin the form. You can't save the form part way through and come back to it. Questions? Contact Taylor at taylor.burnett@fbcyicn.ca Youth Information First Name * Last Name * Legal First Name (if different from above) Legal Last Name (if different from above) Pronouns She/Her She/They He/Him He/They He/She/They They/Them Self-Described If you marked your pronouns as 'self-described', please add your pronouns here Gender Male Female Non-Binary Two-Spirited Self-Described If you marked your gender as 'other', please add your gender here Do you identify as being a member of any of the communities below? Check all that apply to you. Indigenous LGBTQ2S+ Disabilities Newcomer to Canada (immigrant, refugee, 2nd genereation) Parent Other Date of Birth Year Year19731974197519761977197819791980198119821983198419851986198719881989199019911992199319941995199619971998199920002001200220032004200520062007200820092010201120122013201420152016201720182019202020212022202320242025 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Contact Information Email Address * Phone Number Address (include any unit number or PO box) City * Province * Postal Code Your Submission How would you like us to credit you? If you leave this blank, your name will appear on your published submission as your first name and last initial. You can also remain anonymous, have your last name included (19 and over only), or we can credit you with another name of your choice. Tell us a little about your submission! We may publish what you share here to provide context to your submission. If you don't want us to publish what you share in this box, please include a note for us here. Upload a file for your submission Files must be less than 15 MB.Allowed file types: gif jpg jpeg png pdf doc docx avi mov mp3. Upload a file for your submission Files must be less than 15 MB.Allowed file types: gif jpg jpeg png pdf doc docx avi mov mp3. Upload a file for your submission Files must be less than 15 MB.Allowed file types: gif jpg jpeg png pdf doc docx avi mov mp3. Upload a file for your submission Files must be less than 15 MB.Allowed file types: gif jpg jpeg png pdf doc docx avi mov mp3. Upload a file for your submission Files must be less than 15 MB.Allowed file types: gif jpg jpeg png pdf doc docx avi mov mp3. If your file is too big to attach here, please contact Taylor at taylor.burnett@fbcyicn.ca and we'll find another way for you to submit your file. Permission to Use Your Submission * By clicking yes, you give permission for the BCCYICW Committee to use your submission in different platforms including BCCYICW social media, the BCCYICW website, on promotional materials or at BCCYICW events. All submissions will be reviewed by the BCCYICW Promo and Awareness Working Group and are subject to the BCCYICW Editorial Policy. Please contact taylor.burnett@fbcyicn.ca if you have any questions. Yes Media Consent Please complete this section if you are submitting a photo, video or audio recording of yourself. If you submit a photo, video, or audio recording of yourself without completing this section, we will not be able to include it in the campaign. I hereby give the BC Child and Youth in Care Week (BCCYICW) Committee and those acting as its authorized representatives the right and permission to use and/or publish photos/videos/audio recordings of me as outlined below. I hereby waive any right to inspect or approve the finished media. Finished media may include digital or print materials (such as posters, videos, graphics, reports, etc.) and may appear on platforms including but not limited to BCCYICW social media channels (Facebook), the BCCYICW website, and BCCYICW printed materials. Signing this form will be taken as consent with the above. A parent or guardian must sign this release form if the individual photographed/videoed is 18 years old or younger. If the young person is 18 or younger, signatures of both the youth and guardian are required. It is BCCYICW Committee policy that names, ages or addresses are not used to identify youth under the age of 19 in these photos/videos/audio recordings. Social workers, please note that this is in line with MCFD policy for children and youth in care. If you have given Media Consent to the BCCYICW Committee and want it changed, you must notify us immediately at info@fbcyicn.ca. Youth Consent * By clicking the box below, I understand that I am giving consent for the BCCYICW Committee to share photos/videos/audio recordings of me submitted here. Yes, I understand and give consent. No, I understand and do not give consent. Guardian Consent REQUIRED FOR YOUTH AGED 18 AND UNDER. By clicking the box below, I confirm that I am the legal guardian of this youth, and I understand that I am giving consent for the BCCYICW to share photos/videos/audio recordings of this youth that are submitted here. Yes, I understand and give consent. Guardian Name Privacy and Information Consent * We are collecting your personal information here to process your submission to the #YouthInCareAreAwesome Campaign and to contact you about it if necessary. By marking ‘Yes, I consent’ below, you give the Federation of BC Youth in Care Networks permission to collect and use your information as we described above. If you have any questions or need more information, please contact info@fbcyicn.ca. Yes, I consent