Project Inclusion – Delegate Permission Form & Agreement

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Dear Parent/Guardian,

Congratulations! Your child has been nominated to attend the Project Inclusion youth leadership institute from February 1-4 at the Jamestown 4-H Educational Center. Conducted by the Virginia Center for Inclusive Communities, Project Inclusion is a four-day, three-night residential program that allows student participants (called “delegates”) to break barriers, deal with biased behavior, and develop an Action Plan to reduce prejudice in their own schools and communities.  In addition, student participants gain insight into their own lives and values.  Being selected is quite an honor.

Your student can be registered using this link. This information should be filled out by you and your child. We recognize that there is a lot of information to complete. All of it is used to ensure that your child is safe while with us at the program.  Thank you in advance for your cooperation.

 Given that students will be living and working together in close proximity for the retreat, VCIC strongly encourages all participants to be up-to-date with vaccinations, including the most recent COVID-19 booster and flu shot. Taking these precautions in advance of the program will help to reduce risk of infection for participants, promote a safe and healthy learning environment, and allow us to focus on program content during our time together. 

A Project Inclusion Orientation Session will be held for parents/guardians and delegates Wednesday, November 29 at 6:00 pm at Hampton High School. During that session, you will have the opportunity to learn more about Project Inclusion and ask any questions you have.

Click here for a list of things to bring to Project Inclusion.  If you need to contact your child during Project Inclusion, please call the Virginia Center for Inclusive Communities emergency phone at (804) 495-1580.  Messages will be checked regularly and relayed to your child.  Please do not encourage your child to call you.  Doing so removes your child from the Project Inclusion community.  We have a very short time together and every minute is valuable.

Please reach out to VCIC’s Vice President of Programs, Jessica Hawthorne, by phone at (804) 515-7950 or by email at [email protected] if you have any questions.  We look forward to working with you to create a memorable and meaningful experience for your child!

Student Delegate Permission Form & Agreement

Please complete this form by December 14, 2023


Jessica Hawthorne
Vice President of Programs

804-515-7950 ext. 112 [email protected]

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