Thrive Summer Sessions

Eligibility Check

To join the Youth Summer Sessions, participants should meet all of the following criteria:

You are 17-26 years old;

You are a resident of Vancouver Coastal Health service delivery area;

You are facing mental health or substance use challenges.

Signup Form

Full Name *

Phone Number *

Phone Number Type *

Cell Phone

Home Phone

Other

Email address *

Address *

City *

Postal Code *

Date of Birth *

Gender *

Man

Women

Trans man

Trans women

Non-binary

Two-spirit

Other

Prefer not to say

Do you identify as having a mental health condition? *

Yes

No

I'm not sure

If yes to above question, please choose (Check all that apply):

Anxiety

Depression

Bipolar

Schizophrenia

PTSD

Psychosis

OCD

Do you receive support from (Check all that apply):

VGH (inpatient/outpatient)

UBC (inpatient/outpatient)

St. Paul's Hospital (inpatient/outpatient)

AAC

Mental Health Team

EPI

HUB

Other

Please provide a referral contact name and Agency *

Please provide a referral contact phone number *

By checking the box, you give consent to us contact your referral

Additional concerns or other health conditions

Where did you hear about Summer Session program? *

Emergency Contact

Full Name *

Relationship *

Phone Number *

Email Address *

Parent Consent (if under 19)

Full Name

has registered to THRIVE- YOUTH SUMMER SESSIONS. Open Door Group organizes and run these social, recreational events for young adult ages 17-26 years, who are facing mental health challenges.

Age

Parent Name

By checking the box, it indicates that you have been informed of and consent to your minor’s (under the age of 19) participation. No minor will be allowed to participate without a signed consent form

Activities List

BBQ and Shoreline Pick Up and Picnic (Please check all that apply) *

July 9 – Kick Off BBQ

August 6 – Shoreline Garbage Pick Up and Picnic

August 27 – Wrap-Up BBQ

Choose your Activities (Please look at the calendar for reference)

Prioritize your top picks for "Urban Recreation" and "Make it!" from 1-7. (1 being most desirable and 7 being less desirable).

First Pick *

Second Pick *

Third Pick

Fourth Pick

Fifth Pick

Sixth Pick

Seventh Pick

After you have filled out our online form, please expect to hear back from us within 2-3 business days. Make sure to check your spam and junk email folder. Thank you!

Additional Information

Please note the following before submitting this form:

Purpose of Use: The information collected in this form will be used to verify your identity, confirm program eligibility, ensure legal compliance, communicate program updates, and maintain accurate administrative records.

Revocation of Consent: You have the right to revoke your consent at any time by contacting us at This email address is being protected from spambots. You need JavaScript enabled to view it..

Duration of Use: This consent remains valid for as long as deemed necessary unless revoked earlier.

Personal and Sensitive Information: Personal information refers to any data that can identify you, such as your name, email address, phone number, and mailing address. Sensitive information includes details that require additional protection due to their private nature, such as your social security number, financial information, health information, and any other data that could lead to discrimination, identity theft, or other harm if disclosed.

Sensitive Information: We will not use any sensitive personal information provided without obtaining separate explicit consent.

Confirmation Section: By entering your details in this form, you confirm your understanding of the terms and agree to the outlined conditions. By submitting your information through this form, you consent to our collection, use, and handling of your personal and sensitive information in accordance with our privacy policy.