Community Walk for Mental Health - Global Youth Service Day 2021
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Daniel P. McCoy Paula Mahan
Albany County Executive Colonie Town Supervisor
Please join the Town of Colonie Youth Services Division in partnership with the
Albany County Department for Children Youth and Families - Youth Bureau
Global Youth Service Day 2021:
Community Walk for Mental Health
Saturday, May 8, 2021
9:00AM - 1:00PM
The Crossings Park, South Pavilion
580 Albany Shaker Rd
Loudonville, NY 12211
Donation to Benefit:
Volunteer opportunity for students 12 years and older, contact:
Laura Archambault (518) 783-2760 x2101, ArchambaultL@colonie.org or
Valerie.Johson@albanycountyny.gov. Volunteers must register by: Thursday, April 29.
For more information and walker registration, visit www.northernrivers.org/GYSD or
email stephanie.douglas@northernrivers.org. Walkers must register online by: Thursday, May 6.
Group Volunteer Individual Volunteer
Registration Form Registration Form
________________________________________________________ __________________________________________________
Group Name Name Daniel P. McCoy Paula Mahan
Albany County Colonie Town
________________________________________________________ __________________________________________________ Executive Supervisor
Contact Name (21 years or older) School
________________________________________________________ __________________________________________________
Contact Phone Number Address
________________________________________________________
__________________________________________________
Contact Email Address
City/Town
Name, Age
__________________________________________________
State Zip Code
______________________________________ Age: _______
__________________________________________________
______________________________________ Age: _______
Telephone
______________________________________ Age: _______ Global Youth
__________________________________________________
______________________________________ Age: _______
Age Email Service Day 2021
Service Project:
______________________________________ Age: _______ Community Walk for Mental Health
Town of Colonie Youth Services
580 Albany Shaker Road Saturday, May 8, 2021
______________________________________ Age: _______ Loudonville, NY 12211 9:00am - 1:00pm
Attention: Laura Archambault
If registering to volunteer as a group, you must collect signed (518) 783-2760 ex # 2101
photo and parental consent forms for your every member of ArchambaultL@colonie.org
your group.
Albany County Department for
registering for a group you must collect signed photo and Children Youth and Families - Youth Bureau
parental consent forms for your group. 112 State Street
Albany, NY 12207
Community Walk for Attention: Valerie Johnson Donations to Benefit: Northern Rivers
(518) 447-3053
Mental Health Valerie.Johson@albanycountyny.gov Volunteer registration deadline:
Thursday, April 29, 2021
Donations to benefit: Walker registration deadline:
Thursday, May 6, 2021
The Crossings Park, South Pavilion
580 Albany Shaker Rd
Loudonville, NY 12211
Release Form/Parental
Thank you for your interest in Community Walk for Mental Consent for Minors
Global Youth Service Day Health to benefit:
on Saturday, May 8, 2021
All volunteers must complete the release form. If you are
17 years of age or younger, please have your parent/
How do I sign up to volunteer? guardian sign the Parental Consent Form on the bottom
of this page.
STEP 1:
Complete the individual or group volunteer The Albany County Youth Bureau and Town of Colonie Youth
registration form. Services is requesting your consent to allow your child
____________________________ to participate in Global Youth
How can I get involved?
STEP 2: Service Day along with the use of your child’s photo publicly. I
Make sure you sign the release form. If you are Join us to spread awareness about mental health, understand that the images may be used in print publications,
17 or younger, have parent/guardian sign it. educate others about warning signs and resources, online publications, presentations, websites, and social media. I
and eliminate the stigma from asking for help. also understand that no royalty, fee or other compensation shall
STEP 3: become payable to me by reason of such use.
Email/Mail/fax the volunteer registration and How do I sign up to walk?
release forms to: LIABILITY RELEASE: In consideration of Albany County and the
Attention: Laura Archambault STEP 1: Town of Colonie allowing the Participant to participate in GYSD I,
Town of Colonie Youth Services, Chose your time (9:00am - 11:00am or 11:00am - 1:00pm) to the undersigned, do hereby release, forever discharge and agree
580 Albany Shaker Rd., Loudonville, NY 12211 walk and complete the walker registration online at to hold harmless Albany County/Town of Colonie directors,
www.northernrivers.org/GYSD. employees, volunteers and teachers from any and all liability,
Fax: (518) 380-5152 claims or demands for accidental personal injury, sickness or
Phone: (518) 783-2760 x 2101 STEP 2: death, as well as property damage and expenses, of any nature
Email: Archambaultl@colonie.org The walk will take place on Saturday, May 8. Walker packet whatsoever which may be incurred by the undersigned and the
pickup will take place at the South Pavilion, and various Participant while involved in the GYSD activities.
Step 4: educational activities will happen throughout the park. Come
In order to practice social distancing, we will be when you can, stay as long as you'd like, and enjoy the park! ____________________________________________________
offering volunteer opportunities before, during, Participant Name
and after the walk. A volunteer coordinator will STEP 3:
contact you to add you to the schedule. If you choose to do the walk virtually please complete step 1 ____________________________________________________
and a walker packet will be mailed to you. Participant Signature (If 17 or older)
Walker registration is FREE, must be completed by 5:00pm ____________________________________________________
on Thursday, May 6, and donations of any size are welcome.
Print Name of Parent/Legal Guardian (child under 17)
Donations will benefit the programs and services provided by
____________________________________________________
Northern Rivers Family of Services in honor of Mental Health
Signature of Parent/Legal Guardian
Awareness Month.
If you have any questions about the walk, contact:
Stephanie Douglas, Director of Development Yes, I give permission for my child’s photograph to be used.
We will be adhering to all New York State stephanie.douglas@northernrivers.org
COVID-19 Guidelines, including social distancing,
No, I DO NOT give permission for my child’s photograph to
wearing masks, and providing hand sanitizer.
be used.
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