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LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES (323) 793-0331 countywide VIDA voice mail SUMMARY OF THE VIDA PROGRAM
The Vital Intervention Directional Alternatives (VIDA) program was specifically designed by the Los AngelesCounty Sheriff’s Department to assist “at-risk” youth and utilize pro-active, innovative techniques for positiveredirection. The VIDA program is a non-custody, intensive, sixteen (16) consecutive week, youth interventionprogram. Only two (2) classes a year will be conducted. The VIDA program offers treatment, prevention, anddisciplinary components to alter negative behavior. The VIDA program has a high rate of success. VIDA’ssuccess or failure depends directly on the level of commitment and application of the participant and theirfamily.
The VIDA program is a collaborative effort between law enforcement and community-based organizations,with law enforcement being the facilitator and taking the leadership role. It is essential that law enforcementplay a major role in the intervention and overall development of the participants. Generally, law enforcementis the first to make contact with “at-risk” youth. The VIDA program is facilitated by an experienced team ofdeputy sheriffs who possess an expertise in juvenile intervention and prevention techniques. A cadre ofcommunity based volunteers donate their time and expertise to assist in the on-going success of theprogram.
The VIDA program is designed to positively redirect male and female “at risk” youth between the ages ofeleven to seventeen and a half (11-17½) to partner with the influences of law enforcement, rather than theinfluences of the gang culture and other criminal elements. Participants are referred from the court, probation,patrol deputies, detective bureau, school districts or from a parent requesting their child be enrolled into theVIDA program. The VIDA program will not accept applicants who have a propensity toward violence,“hardcore” offenders, or applicants who might suffer from a mental illness. The VIDA staff shall intervieweach participant and their parent(s) and/or legal guardian(s). The VIDA staff will determine who is enrolled,dropped or terminated, based on the totality of the participant’s history and/or the parent(s) and/or legalguardian(s) commitment to the program. The parent(s) and/or legal guardian(s) must fully support the VIDAprogram for their child to be enrolled. There is an enrollment fee of $75.00 which will purchase physicaltraining clothing, drug test kits/fees and educational tours for the participants.
The VIDA participants will meet as a class on Saturday mornings between 7:45 a.m. and 4:00 p.m. and mid-week from 7:00 p.m. and 9:00 p.m. Ask your VIDA staff instructors for your site’s hours of operation. TheSaturday sessions will encompass: Physical training, Close Order Drill (marching), tutoring, life skills,educational tours, tour of the Los Angeles County Jail and community service. The mid-week counselingsessions will facilitate family counseling for the parent(s) and/or legal guardian(s) and their child. Theparent(s) and/or legal guardian(s) are responsible for transporting their child to the Saturday program and themid-week counseling sessions. If the parent(s) and/or legal guardian(s) are not able to transport their child tothe VIDA program, they will be dropped from the VIDA program; and a new plan of action will be facilitatedwith the family. The Sheriff’s Department will transport the participants to the community service sites andeducational tour locations.
There are nine core components to the VIDA program. Each component is designed to identify the negativeinfluences that have resulted in an individual’s referral to the program. VIDA is designed to redirect theparticipant’s negative behavior into positive and socially acceptable behavior. Choices and consequenceswill be stressed throughout the program. The VIDA program builds self-esteem and will assist in breaking thecycle of criminal behavior; while facilitating the participant toward success. The VIDA staff is here to help you graduate, not watch you fail! ENROLLMENT: The parent(s) and/or legal guardian(s) and the participant shall be present for the enrollment
process. This session involves a detailed assessment and discussion of parental responsibilities. Past,
present and future activities of the participants will be discussed; and expectations for their successful
completion of the program. The parent(s) and/or legal guardian(s) shall sign numerous waivers allowing their
child to participate in the VIDA program.
INTAKE NIGHT: Participants and their parent(s) and/or legal guardian(s) are brought together as a class.
Guest speakers will include: Judges, deputy sheriffs, probation officers, counselors and former gang
members/drug addicts will confront the participants and discuss the harsh realities of making poor choices
and the reality of incarceration. Additionally, poor parenting skills will be challenged and new skills will be
facilitated.
FAMILY COUNSELING: A community based organization will provide on-going counseling services to all the
participants and their family members. It is Mandatory that a parent and/or a legal guardian attends the mid-
week counseling session.
COMMUNITY SERVICE: Under the direction of the VIDA staff, each participant will be required to perform
thirty-two hours of community service, which will be applied to any court ordered or mandated community
service terms. Community services include, but limited to: graffiti removal, property and community
revitalization projects.
PHYSICAL TRAINING: Each participant is required to perform various physical training calisthenics that are
outlined in the President’s Fitness Challenge such as: Sit-ups, push-ups, jumping jacks, leg lifts,
jogging/sprinting, and marching drills. Deputy sheriff’s will assist the participants with the physical training
component of the program.
REALITY ORIENTATION: This component is designed to “shock” the participants’ conscience and awaken
them to the reality of life and making poor choices. The VIDA participants and staff will visit the following
facilities: Los Angeles County Jail, California Youth Authority, California State Prison, neonatal unit of a local
hospital, and the Museum of Tolerance. The Sheriff’s Department will transport the participants to the above
listed facilities. Tour days and time will vary based on the availability of the above listed facilities.
EDUCATION & CAREER GUIDANCE: Tutors will assist the VIDA participants with English, mathematics,
resume, job interview and life skills. The Pacific Institute’s “Pathways to Excellence” will be facilitated. The
VIDA staff will secure working professionals to assist the VIDA participants with their career choices.
DRUG TESTING: Each participant is required to submit a minimum of three (3) urine samples, which will be
tested for (18) eighteen controlled substances, marijuana, and alcohol. If the participant tests positive for any
of the above listed substances, he/she may have to submit to additional drug tests. The tests will be
administered and collected by deputy sheriffs. Same gender supervision will be in-place at all times during
the collection of the samples. If the participant continues to test positive, he/she may be directed to enroll in
a drug rehabilitation program or rehabilitation facility. The VIDA staff and our community based organizations
will assist the participant in locating an acceptable rehabilitation program.
HOME & SCHOOL INSPECTIONS: The VIDA staff will conduct several random welfare checks of the
participant’s home and monitor the participants at their respective schools.
To reserve your position in the Los Angeles County Sheriff’s Department VIDA program, submit yourcompleted application (pages 1-18) as soon as possible. Class size is limited and will be filled on a firstcome, first serve basis.
Please direct any questions to the Los Angeles County Sheriff’s Department VIDA staff at (323) 793-0331.
Thank you for your interest in the Los Angeles County Sheriff’s Department, Vital Intervention DirectionalAlternatives program. We are looking forward to assisting your family.
LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES ENROLLMENT INSTRUCTIONS
The following instructions will assist the applicant in successfully enrolling into the VIDA program. The
interview application is located on pages 1, 2, and 3. The interview is divided into the below listed seven
categories:
•
Participant’s History
Participant’s Children
Participant’s Medical History
Mother’s History
Participant’s School
Father’s History
Participant’s Criminal History
Do not write in the grey shaded area marked “FOR SHERIFF’S USE ONLY” Page #1: Participant’s History box: This section only applies to the minor who will be attending the VIDA
program. DO NOT place any of the mother’s or father’s information in this section. “Place of birth” indicates
the state (for example: California = CA). If the participant was not born in the United States, indicate the
country (for example: Mexico). Under the emergency contact phone numbers, DO NOT put the mother’s or
father’s phone numbers. Place the phone numbers of a local relative or trusted friend. List the name and the
relationship of the emergency contact person (for example: John Smith, uncle).
Page #2: Participant’s Medical History: Place a “X” in any of the medical condition(s) or medication(s) that
applies to the participant. List additional medical condition(s) or medication(s) the participant uses that are not
listed in the check-off boxes. The medical questionnaire is designed for your child’s safety; DO NOT guess at
any answer. If you do not know the correct answer, check with your doctor.
Participant’s School: List the school the participant will be attending while enrolled in the VIDA program.
Participant’s Criminal History: If the VIDA staff discovers the participant is a current or ex-gang member,
tagger, or a party crew associate, the participant will have 160 hours added to their program, unless the
group or click was listed. If the participant is an associate of any gang, tagging or party crew, you must list
the name of the group or click. Even if the participant just “hangs around” or “kicks it” with any of the listed
group(s), you must list the group or click.
Participant’s Children: Does the participant have children? If yes, list them.
Page #3: Mother’s and Father’s History: If the participant lives with their mother/father, just place a “X” in the
“same address of the participant” box. It is not necessary to reprint the mother’s/father’s address. If the
participant has no contact with the mother/father, place a “X” in the no contact with the mother’s/father’s box. If
the participant does not live with either the mother/father, but with a grandmother/grandfather, or otherlegal
guardian(s), place their names in the gender specific mother/father categories. The step/foster mother and
father shall be placed in the mother and father area of the enrollment application.
There are ten (10) waivers the parent(s) and/or the legal guardian(s) shall sign to enroll their child into the Los
Angeles County Sheriff’s Department VIDA program. After the enrollment application has been completed,
please refer to page 18 for the final instructions. Please note, the search waiver only pertains to the
participant, not the parents.
Page 9 - Photo and Written Material Release Page 16 - Statement of Health for Minor (parent) Page 17 - Statement of Health for Minor (physician) Page 18 - Consent to Criminal History CheckPage 19 - Final Instructions LOS ANGELES COUNTY SHERIFF’S DEPARTMENT
VITAL INTERVENTION DIRECTIONAL ALTERNATIVES
INTERVIEW APPLICATION
FOR SHERIFF’S USE ONLY – DO NOT WRITE IN THIS AREA
VIDA START DATE: ________-________-________ CLASS#: ________ REFERRED BY: ___________________ CHARGE(S): _______________________ JAIN: ________________________ STATUS: ENROLLED □ RECYCLED □ DROPPED □ TERMINATED □ RETURNING GRADUATE □
LIST REASON(S) FOR RECYCLE, DROP, TERMINATION OR RETURNING GRADUATE □ RECYCLED FROM CLASS #:________ SITE ________
VIOLENT OFFENDER □ MEDICAL CONDITION(S) □ TRANSPORTATION □ PARENT(S) UNCOOPERATIVE □ OTHER (LIST BELOW) □ REASON: ___________________________________________________________________________________ NEXT COURT DATE: _______/_______/_______ DEPUTY REVIEWING APPLICATION: _____________________________________ EMPLOYEE #: _________________ DATE: ________-________-________ PARTICIPANT’S HISTORY
TODAY’S DATE: ________-________ -________
LAST NAME: _____________________________________________________ FIRST: _____________________________________ MI: ______ AGE: _______ DATE OF BIRTH: ________-________-________ HAIR: _______________ EYES: ________________ HEIGHT: ____________ WEIGHT: ______________ SEX: ______ RACE: _____________________ DRIVER’S LICENSE OR IDENTIFICATION CARD #: ________________________________ STATE: ________ MYSPACE ACCOUNT NAME: _____________________________________ FACEBOOK ACCOUNT NAME: __________________________________________ OTHER EMAIL ADDRESS: ____________________________________ HOME ADDRESS: ____________________________________ APT #: ______________ CITY: _______________________________________________________ ZIP: _______________ HOME PHONE #: ( ) ___________-______________ WORK #: ( )___________-_____________ CELL #: ( ) ___________-_____________ OTHER: ( ) ___________-_____________ LIST TATTOOS: _______________________________________________________________________ SCARS: ________________________________________ HOUSEHOLD TYPE: PARTICIPANT LIVES WITH BOTH PARENTS □ PARENTS ARE DIVORCED OR SEPARATED □
IF THE PARENTS ARE DIVORCED OR SEPARATED, WHO DOES THE PARTICIPANT LIVE WITH: MOTHER □ FATHER □ JOINT □ DOES THE PARTICIPANT LEGALLY DRIVE A MOTOR VEHICLE: NO □ YES □ → LIST MOTOR VEHICLE INFORMATION BELOW VEHICLE TYPE: ______________________ MODEL: _______________________ COLOR: _______________ LICENSE PLATE #: _______________________ EMERGENCY CONTACT: DO NOT LIST MOTHER OR FATHER; LIST RELATIVE OR FRIEND
NAME OF EMERGENCY CONTACT: __________________________________________________ RELATIONSHIP: ________________________________
ADDRESS: _______________________________________________________________ APT: __________ CITY: _______________________________________
WORK #: ( ) __________-____________ CELL #: ( ) ___________-____________ HOME PHONE #: ( ) __________-____________ PARTICIPANT’S MEDICAL HISTORY
SEIZURES □ ASTHMA □ RITALIN □ ADDERAL □ DEXEDRINE □ PROZAC □ WELLBUTRIN □ XANAX □ PAXIL □
ZOLOFT □ KLONOPIN □ RISPERDAL □ CONCERTA □ ALLERGIC TO BEE STINGS: NO□ YES□→ TYPE OF REACTION (LIST BELOW) ALLERGIC TO PENICILLIN: YES □ NO □ OTHER MEDICATION(S) ALLERGIC TO: _______________________________________________________ OTHER MEDICATION(S) THE PARTICIPANT TAKES ON A DAILY BASIS: ____________________________________________________________________
ADDITIONAL MEDICAL CONDITION(S):__________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________ PARTICIPANT’S SCHOOL
SCHOOL: __________________________________________ CITY: _____________________________ PHONE #: ( ) ___________-_____________ GRADE: ________ GRADE POINT AVERAGE: 4.0=A□ 3.0=B□ 2.0=C□ 1.0=D□ 0.0=F□ ATTENDANCE: GOOD □ FAIR □ POOR □ WHAT TYPE OF SCHOOL DOES THE PARTICIPANT ATTEND: CONVENTIONAL□ CONTINUATION□ PROBATION□ HOME SCHOOL□ PARTICIPANT’S CRIMINAL HISTORY
GANG: _________________________________ TAGGING CREW: _______________________________ PARTY CREW: _______________________________ PRIOR ARREST OR CITES: FIGHTING □ VANDALISM □ TRUANCY □ THEFT □ TOBACCO □ MARIJUANA □ DRUGS (LIST ) □ ROBBERY□ BURGLARY □ GRAND THEFT AUTO □ SELLING MARIJUANA □ SALES OF NARCOTICS (LIST TYPE OF DRUGS) □ OTHER: _____________________________________________________________________________________________________________________________ IS THE PARTICIPANT CURRENTLY ON PROBATION: NO □ YES □ → FOR WHAT CRIME: ___________________________________________ PROBATION OFFICER’S NAME: __________________________________________________________ PHONE #: ( ) ___________-_____________ DOES THE PARTICIPANT HAVE CHILDREN?
LAST NAME: ________________________________ FIRST: _____________________________ SEX: ____ AGE: _____ DATE OF BIRTH: _____/_____/_____ LAST NAME: ________________________________ FIRST: _____________________________ SEX: ____ AGE: _____ DATE OF BIRTH: _____/_____/_____ DOES THE PARTICIPANT HAVE SIBLINGS
NO □ YES □ → LIST BELOW (LIST OLDEST TO YOUNGEST, USE THE BACK OF THIS FORM TO ADD ADDITIONAL SIBLINGS) LAST NAME: _______________________________________ FIRST: ____________________________________ DATE OF BIRTH: _______/_______/_______ LAST NAME: _______________________________________ FIRST: ____________________________________ DATE OF BIRTH: _______/_______/_______ LAST NAME: _______________________________________ FIRST: ____________________________________ DATE OF BIRTH: _______/_______/_______ LAST NAME: _______________________________________ FIRST: ____________________________________ DATE OF BIRTH: _______/_______/_______ MOTHER’S HISTORY OR LEGAL GUARDIAN
IF NOT THE BIOLOGICAL MOTHER, LIST RELATIONSHIP: BIOLOGICAL MOTHER DECEASED □
GRANDMOTHER □ AUNT □ FOSTER PARENT □ STEPMOTHER □ OTHER: __________________________________________ LAST NAME: ___________________________________________ FIRST: _____________________________________ MIDDLE: ________________________ DATE OF BIRTH: ________-________-________ HAIR: _______________ EYES: ________________ HEIGHT: ____________ WEIGHT: ______________ RACE: ________________ SOCIAL SECURITY #: __________-________-____________ NAME OF EMPLOYER: _____________________________________ YEARLY INCOME: $____________________ HIGHEST GRADE GRADUATED: HIGH SCHOOL □ AA □ BA/BS □ ADVANCED DEGREE □ DRIVERS’ LICENSE #: __________________ STATE: ______ SAME ADDRESS AS THE PARTICIPANT □ NO CONTACT WITH THE PARTICIPANT □ HOME ADDRESS: _________________________________________________________________________________________________ APT#: ______________ CITY: _________________________________________________________ ZIP: _______________ HOME PHONE #: ( ) ___________-____________ WORK #: ( ) ___________-____________ CELL #: ( ) ___________-____________ PAGER #: ( ) __________-_____________ IS MOTHER ON PROBATION OR PAROLE: NO □ YES □ → FOR WHAT CRIME: _____________________________________________________ P/O’S NAME:_______________________________________________ AGENCY: ____________________ PHONE #: ( ) ___________-____________ MOTHER IN CUSTODY: NO □ YES □ → COUNTY JAIL □ STATE PRISON □ TYPE OF CRIME: _______________________________ FATHER’S HISTORY OR LEGAL GUARDIAN
IF NOT THE BIOLOGICAL FATHER, LIST RELATIONSHIP: BIOLOGICAL FATHER DECEASED □
GRANDFATHER □ UNCLE □ FOSTER PARENT □ STEPFATHER □ OTHER: __________________________________________ LAST NAME: ___________________________________________ FIRST: _____________________________________ MIDDLE: ________________________ DATE OF BIRTH: ________-________-________ HAIR: _______________ EYES: ________________ HEIGHT: ____________ WEIGHT: ______________ RACE: ________________ SOCIAL SECURITY #: __________-________-____________ NAME OF EMPLOYER: _____________________________________ YEARLY INCOME: $____________________ HIGHEST GRADE GRADUATED: HIGH SCHOOL □ AA □ BA/BS □ ADVANCED DEGREE □ DRIVERS’ LICENSE #: __________________ STATE: ______ SAME ADDRESS AS THE PARTICIPANT □ NO CONTACT WITH THE PARTICIPANT □ HOME ADDRESS: ________________________________________________________________________________________________ APT#: ______________ CITY: ________________________________________________________ ZIP: _______________ HOME PHONE #: ( ) ___________-___________ WORK #: ( ) ___________-____________ CELL #: ( ) ___________-____________ PAGER #: ( ) __________-____________ IS FATHER ON PROBATION OR PAROLE: NO □ YES □ → FOR WHAT CRIME: ______________________________________________________ P/O’S NAME:______________________________________________ AGENCY: ____________________ PHONE #: ( ) ___________-___________ FATHER IN CUSTODY: NO □ YES □ → COUNTY JAIL □ STATE PRISON □ TYPE OF CRIME: ____________________________________ LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES WAIVER OF RELEASE OF CLAIMS AND INDEMNITY AGREEMENT
In consideration for allowing, ________________________ (hereinafter referred to as minor) to participate in the Los Angeles County Sheriff’s Department VIDA program, I_____________________________________, (parent or guardian of minor) acting on behalf of the minor, hereby waive, release, and discharge the County of Los Angeles, Sheriff Leroy Baca, the Sheriff of the County of Los Angeles, and officers, agents, servants,employees or officials of Los Angeles County or the Los Angeles County Sheriff’s Department for personal injuryand property damage which may hereinafter occur to the minor as a result of the minor’s participation in the LosAngeles County Sheriff’s Department VIDA program, also known as the Juvenile Intervention Program.
That the County of Los Angeles, Leroy Baca, the Sheriff of Los Angeles County, officers, agents, servants,employees or officials of the County of Los Angeles or the Los Angeles County Sheriff’s Department, and eachof them, shall not be responsible or liable for any injury, damage, loss, or expense to the minor or me, or to myproperty or the minor’s property, incurred while accompanying any member or members of the Los AngelesCounty Sheriff’s Department during the performance of their official duties whether the damage, loss or expenseoccurs by reason of negligence, dangerous condition of public property or otherwise.
For myself, my heirs, executors, administrators, I agree to defend, indemnify and hold harmless the County ofLos Angeles, Sheriff Leroy Baca, the Sheriff of the County of Los Angeles, and officers, agents, servants,employees, or officials of the County of Los Angeles, against any and all manner of action, claims, cause ofaction, suits, debts, demands or damage or liabilities or expense of any kind and nature incurred or arising byreason of any actual or claimed act or omission of the minor, or injury sustained by minor, while participating inthe Los Angeles County Sheriff’s Department VIDA program. This includes claims brought by the minor on behalfof the minor.
In the event of sudden illness, accident or injury which may occur while said minor is participating in the LosAngeles County Sheriff’s Department VIDA program, and neither the parents, guardian, or designated familyphysician can be contacted, I hereby give my consent to any physician licensed in the State of California pursuantto Civil Code Section 25.6 to perform such emergency medical treatment as may be necessary under thecircumstances. I authorize any member of the Los Angeles County Sheriff’s Department to give consent onbehalf of the minor for such emergency medical treatment as may be necessary.
I hereby represent that I have carefully read and understand the contents of this document and sign the sameof my own free will.
Parent/Guardian (print):_______________________________________ Parent/Guardian (signature):__________________________________ Date:____________ Parent/Guardian (print):_______________________________________ Parent/Guardian (signature)___________________________________ Date:____________ Witness (signature): _______________________ Employee #: _________ Deputy will sign as witness during enrollment LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES CONSENT TO SEARCH WAIVER
Part two of the Waiver of Release of Claims and Indemnity Agreement In consideration for allowing the minor to participate in the Los Angeles County Sheriff’s Department, VitalIntervention Directional Alternatives program, this consent to search waiver only extends to the minor,__________________________________________________, who is a participant in the Los AngelesCounty Name of minorSheriff’s Department Vital Intervention Directional Alternatives program. I, ___________________________________________, (parent or legal guardian of the above named minor) Name of parent or legal guardianacting on behalf of the minor, hereby give, release, and discharge the County of Los Angeles, Sheriff LeroyD. Baca, Sheriff of Los Angeles County, and officers, agents, servants, employees or officials of Los AngelesCounty, my written permission to any police officer or deputy sheriff as defined in chapter 4.5 (commencingwith section 830) of the California Penal Code to search my property or property under my control any time ofthe day or night with or without a warrant.
I,________________________________________, do hereby grant unconditional authorization to anypolice Name of minorofficer or deputy sheriff as defined in chapter 4.5 (commencing with section 830) of the California PenalCode, to search my person and property, or property under my control, any time of the day or night, with orwithout a warrant.
The scope of the search will include, but not be limited to the following: the minor’s person, bedroom, desks,computer systems including hard drives and software, closets, dressers, night stands, clothing, duffle bags,suitcases, restroom area, locked and unlocked containers, vehicles, and school or gym lockers.
Items to be searched for will include, but not be limited to the following: controlled substances and articles ofparaphernalia, marijuana and articles of paraphernalia, articles commonly used in the sales of a controlledsubstance, alcoholic beverages, weapons, gang or tagging paraphernalia, records or information that mayindicate criminal activity and property that has been listed as stolen in a police report.
I hereby represent that I have carefully read and understand the contents of this document and sign
the same of my own free will. I hereby agree to the conditions of the Consent to Search as long as I am
enrolled in the VIDA program. I understand that as a result of any search, any item(s) of an illegal nature will
be seized and may be used in a court of law for the purpose of a criminal prosecution.
Parent/legal guardian (signature):_______________________________ Date: __________ Parent/legal guardian (signature):_______________________________ Date: __________ Minor (signature): ____________________________________________ Witness (signature): __________________________________________ Deputy will sign as witness during enrollment LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES ALCOHOL AND DRUG WAIVER
Each minor participating in the VIDA program is required to submit a minimum of three (3) urine samples thatwill show the presence or absence of drugs and/or alcohol in their body. The urine samples will be tested foreighteen controlled substances, marijuana, and alcohol. The results of these tests will be used by the VIDAstaff and our community based organizations to assess a plan of treatment for the participant. The minor’sparent(s)/legal guardian(s), probation officer, detective bureau, juvenile court, ACTION counseling, or theparticipant’s referring school district will be informed of the test results and the type of substance(s) found inthe sample.
The VIDA staff will obtain the samples at a time and place when the minor least expects to be tested. Thisrandom collection ensures the minor stays “clean” at all times and not just a few days before the tests. Samegender supervision will be in-place at all times during the collection of the samples.
If the participant refuses to submit or fails to submit a urine sample for testing, the refusal/failure will betreated as a positive test. The minor will be referred back to the court, probation, detective bureau, or thereferring entity for further action. Based on the totality of the circumstances, the minor may be recycled into afuture VIDA class. The goal of the drug testing is to identify the participants who might be addicted to drugsand/or alcohol and treat their addiction(s).
If the participant continues to test positive, he/she will be directed to enroll in a drug rehabilitation facility orattended drug counseling classes. The VIDA staff and our community based organizations will assist theparticipant and their families in locating an acceptable rehabilitation facility. Only under the most compelling circumstances; and after all other options has failed, the positive drug test(s)may be used for criminal prosecution. I hereby represent that I have carefully read and understand the contents of this document and sign the sameof my own free will.
Parent/legal guardian (print):__________________________________ Parent/legal guardian (signature):______________________________ Date:____________ Parent/legal guardian (print):__________________________________ Parent/legal guardian (signature):______________________________ Date:____________ Minor (print): ______________________________________________ Minor (signature): __________________________________________ Date: _____________ LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES RELEASE OF SCHOOL RECORDS
I,____________________________________________,the parent(s)/legal guardian(s) of the minor _____________________________________________________,hereby give my written permission to Name of minor the following school____________________________________________, to release all school records Name of school(attendance, grades, and discipline records) that pertain to the above mentioned minor upon request by anydeputy sheriff or police officer, as defined in chapter 4.5 (commencing with section 830) of the CaliforniaPenal Code. The minor is a participant in the Los Angeles County Sheriff’s Department, Vital Interventionand Directional Alternatives (VIDA) program.
I additionally authorize the school to contact the Los Angeles County Sheriff’s Department VIDA staffwhenever my son or daughter misses two or more consecutive days of school, is tardy, disruptive in class,violates any school rule, suspended, expelled, transfers to another school, or had negative contact with theschool police.
This waiver shall remain in effect until the minor’s eighteenth (18) birthday, or until revoked in writing by theparent/legal guardian.
I hereby represent that I have carefully read and understand the contents of this document and sign the sameof my own free will.
Parent/legal guardian (print): _________________________________ Parent/legal guardian (signature): _____________________________ Date:____________ Parent/legal guardian (print): _________________________________ Parent/legal guardian (signature): _____________________________ Date:____________ Minor (print): _____________________________________________ Minor (signature): __________________________________________ Date:____________ LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES COUNSELING AGREEMENT/SHARING OF DATA
The counseling component of the VIDA program is a mandatory and vital component of the VIDA program. Iagree to attend and participate with my child in counseling as directed by the VIDA staff, community basedorganizations, courts, parole officers, probation officers, case managers, social workers, twelve step supportgroups, Department of Family and Children Services (DCFS) and tutoring programs as needed for the wellbeing of the family unit. If the parent(s) and/or legal guardian(s) refuses to attend counseling, missed two ormore counseling sessions, more then 30 minutes late to any two (2) counseling sessions within the sixteenweek program, the participant may be dropped or terminated from the VIDA program. Substance abuse is not just an individual problem, it is a family problem. Generally, drug or alcohol abuse is
the result of a deeper, underlying issue (i.e. problems at home, school, and/or low self-esteem, etc.) In other
cases, children and teenagers learn from example. These examples may be learned from family members or
friends. As parents, we set these examples by what we do, not by what we say. If the parent(s) and/or legal
guardian(s) or other family members are using illegal drugs or abusing alcohol, they may be asked to enroll
into a drug or alcohol counseling/rehabilitation program.
I understand if there are any costs associated with a drug and/or alcohol rehabilitation center, it is my (theunder signed) responsibility to cover these costs and is not the responsibility of the VIDA program or thecommunity based organizations. There are many free alcohol and narcotic twelve step support groupslocated throughout the County of Los Angeles. The VIDA staff or our community based organizations willdirect you to the nearest support group.
Additionally, the Los Angeles Sheriff’s Department will share the mental heath data, medical and substanceabuse data collected from the families enrolled in the VIDA program with the court, probation, communitybased originations counselors and educational institutions for the purpose of intervention, meta-analysis, andthe well being of the participants and their family.
I hereby represent that I have carefully read and understand all the contents of this document and sign thesame of my own free will. Parent/legal guardian (print): _________________________________ Parent/legal guardian (signature): _____________________________ Date:____________ Parent/legal guardian (print): _________________________________ Parent/legal guardian (signature): _____________________________ Date:____________ LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES `PHOTO AND WRITTEN MATERIAL RELEASE
In consideration for allowing,___________________________, (hereinafter referred to as minor) to participate in the Los Angeles County Sheriff’s Department VIDA program, I_____________________________________, Parent/legal guardian’s name(parent or guardian of minor) acting on behalf of the minor, hereby give, release, and discharge the County ofLos Angeles, Sheriff Leroy D. Baca, Sheriff of the County of Los Angeles, and officers, agents, servants,employees or officials of Los Angeles County, my written permission to copyright or publish all photographs, films,drawings and written material in which the minor appears in and/or have written, while involved in the VIDAprogram. I further agree that VIDA may transfer, use or cause to be used, these photographs, films, drawings,and written material for any and all exhibitions, public display, publications, commercials, art and advertisingpurposes, without limitations, reservations, or any compensation, other than a receipt of which is herebyacknowledged.
I hereby represent that I have carefully read and understand the contents of this document and sign the sameof my own free will.
Parent/legal guardian (print):_________________________________ Parent/legal guardian (signature):_____________________________ Date:____________ Parent/legal guardian (print):_________________________________ Parent/legal guardian (signature)______________________________ Date:____________ Minor (print):__________________________________________ Minor (signature)_______________________________________ Date:____________ LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES PHYSICAL TRAINING CLOTHING
Participant’s name: ___________________________________________
Waist size in inches: (Under 27) (28-32) (32-38) (38-42) (42-50)
Height: ________ Weight: _________
All items are embroidered with the VIDA logo
Each participant is required to maintain their physical training clothing in good order. If the participant lose,
vandalize, or destroys their physical training clothing, they will have up to 160 hours added to their program.
The participant must present their physical training clothing to the VIDA staff for review, before they will be
allowed to graduate. Upon the participant’s graduation, they will be allowed to keep their physical training
clothing.
Parent/legal guardian (print):_________________________________ Parent/legal guardian (signature):_____________________________ Date:____________ Parent/legal guardian (print):_________________________________ Parent/legal guardian (signature)______________________________ Date:____________ Minor (print):_____________________________________________ Minor (signature)__________________________________________ Date:_____________ LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES 1) ATTENDANCE:
VIDA is a sixteen (16) consecutive week program that requires the participant to attend an eight (8) hoursession on Saturday mornings and a two (2) hour mid-week counseling session. On occasion, the Saturdayand/or mid-week hours may be extended or additional days maybe be added. The Saturday program consistsof physical training, Close Order Drill (marching), community service, tutoring, life skills and educational tours.
The mid-week program will entail counseling for both the participant and their parent(s) and/or legalguardian(s). Due to logistics, the educational tours may be conducted on any day of the week. Theparticipant shall complete each of the above mentioned components or the participant will earn a “fail” for thatspecific day. A fail is equal to one (1) unexcused absence. Excused absence:
A parent and/or legal guardian must provide the VIDA staff with a handwritten note or phone call, excusing
the participant’s from any day which VIDA is in session. The VIDA must approve each absence or it will be
considered an unexcused absence. If the participant is too ill to attend the VIDA program, the participant
shall stay home, all day, on that specific day. With a valid excuse and the permission of a parent and/or legal
guardian, coupled with the permission of the VIDA staff, a participant may miss a total of two days, within
the sixteen (16) week period. The participant will fail the VIDA program if he/she missed three (3) or more
classes.
Unexcused absence:
The participant will fail the VIDA program if he/she has one or more unexcused absence(s). If the
participant is mandated to the VIDA program by the court, probation, or detective bureau, he/she may be
subjected to criminal prosecution and/or fines based on their present case.
2) ARRESTS AND CITATIONS:
Any participant who is arrested and/or issued a citation while in the VIDA program may have up to 160 hours
added to their program. If the participant is mandated to the VIDA program by the court, probation, or
detective bureau, he/she may be subjected to criminal prosecution and/or fines based on their present case.
Within (24) twenty-four hours of an arrest and/or citation, it is the participant’s responsibility to inform the
VIDA staff of the circumstances surrounding the police contact. Additionally, the participant is to provide the
VIDA staff with copies of their citation(s) he/she have received while in the VIDA program. While participating
in the VIDA program, any criminal act committed between the participants or directed towards the VIDA staff
(i.e., assault, battery, vandalism, threats of violence, theft, etc.) shall not be tolerated. The VIDA staff has a
“zero tolerance” policy for all criminal acts. If the VIDA staff witnesses or receives information that a VIDA
participant had committed a criminal act, the person responsible for committing said act will be detained,
pending a criminal investigation.
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3) DRUG AND ALCOHOL TESTING:
During the sixteen (16) week program, the VIDA staff will randomly collect a minimum of three (3) urine
samples from the participant. The urine samples will be tested for eighteen (18) controlled substances,
marijuana (THC), and alcohol. Same gender supervision will be in-place at all times during the collection of
the samples. If the participant tests positive for any controlled substance(s), marijuana, or alcohol, they may
be required to attend drug and/or alcohol counseling sessions. These additional counseling sessions are
NOT included in the mid-week counseling sessions. The participant will be required to spend additional time
in counseling. The participant will also be subjected to additional drug testing. A positive drug test will be
forwarded to the court, probation, detective bureau, the referring school district and the participant’s parent(s)
and/or legal guardian(s). The goal of the drug testing is to treat the participant for their drug addiction. Only
under the most compelling circumstances; and after all other options have failed, the positive drug test may
be used for criminal prosecution.
4) SCHOOL:
It is mandatory under the California Education Code (commencing with section 48260) that all minors attendschool or a school based program. The parent(s) and/or legal guardian(s) are also obligated to compel theminor to attend school. If the parent(s) and/or legal guardian(s) fails to meet their obligation, they may beguilty of an infraction and subjected to criminal prosecution pursuant to Article 6 (commencing with Section48290) of Chapter 2 of Part 27. At the direction of the VIDA staff, school attendance reports may be due onthe first Saturday of each month. The participant must be respectful to all their school staff, improve his/hergrades, attendance and citizenship. At the direction of the VIDA staff, the participant may be required to bringproof of their attendance and grades each month while they are attending the VIDA program. Students offtrack will bring written proof of being off track. 5) DRESS CODE:
The dress code was not created to punish the VIDA participants. Our goal is to keep the participants frombeing killed or injured due to what they are wearing. No baggy clothing or attire which may be described as“gangster” style or “sagging” will be allowed. No pant’s sizes larger than two inches over the participant’swaist size will be allowed. No canvas belts with military style buckles, with a letter, number, or icon on thebelt buckle will be permitted. All shoelaces will be black or white and properly laced (no mixed colors). Allother colored shoelaces must be approved by the VIDA staff. All “gang attire” or contraband will beconfiscated on site by the VIDA staff and returned to the parent(s) and/or legal guardian(s) at the end of theday. Parent(s) and/or legal guardian(s) are to remove all “gang attire” from the participant. The VIDA staffwill assist the parent(s) and/or legal guardian(s) with the identification of “gang” and “tagging” attire. Hair styles:
The participant will maintain a well groomed hairstyle, which does not restrict their vision, and does not qualify
as eccentric. Long hair shall be worn in a bun or if it’s too short to be placed in a bum, placed in a ponytail.
The dying of the participant’s hair to any “unnatural” color is NOT permitted. Based on the above guidelines,
the VIDA staff will determine what clothing and/or hair styles are or are not acceptable.
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Personal hygiene:
The participant shall maintain good personal hygiene. Mustaches and beards are not permitted in the VIDA
program. The participant may only have a beard or mustache with the approval of the VIDA staff. The
participant shall articulate to the VIDA staff why he must have a beard or mustache. Piercing or tattooing of
the participant’s body must be approved by the participant’s parent(s) and/or legal guardian(s). As a
reminder, it is an infraction/misdemeanor under sections 652/653 of the California Penal Code for any person
to “body pierce or tattoo” a minor without a parent and/or legal guardian’s permission.
Saturday program:
The participant shall wear all of their issued VIDA clothing on Saturday morning and no additional clothing
shall be worn (except gender specific undergarments and one pair of socks). No jewelry, gaming devices,
ipod (or similar devices) perfume, cologne, or watches shall be worn. Religious jewelry may be worn as long
as it does not present a safety hazzard and is out of view. Make-up will not be applied unless it is for a
medical condition(s).
6) RESPECT: Rules of Courtesy
The participant will be respectful and courteous to everyone. Deputy sheriffs, volunteers, and fellow
participants shall be referred to as “Sir” or “Ma’am” unless directed otherwise by the VIDA staff. Only
“positive” dialogue will be exchanged between the participants. The use of “foul” language will immediately
result in a research paper or other type or discipline. Remember, fear is not respect.
7) HOMEWORK/RESEARCH PAPERS:
The VIDA staff and/or tutors will assign homework to the participant for his/her academical enrichment. The
VIDA staff may assign a research paper(s) to the participant if he/she violated any of the rules, or as a
method to fully understand the participant’s actions. The topic of the research paper will reflect the rule(s)
which the participant violated. Completing and submitting ALL the homework and research paper(s) to the
VIDA staff is a mandatary requirement for graduation. Homework assignments and research papers are due
within seven (7) days of being assigned, unless otherwise indicated by the VIDA staff. If the VIDA staff
and/or tutors does not assign a homework assignment, the participant’s homework assignment will be to read
three (3) newspaper, magazine or internet articles. The participant shall write one paragraph on each of their
chosen articles and submit both the articles and the paragraphs to the VIDA staff Saturday morning for
review. The VIDA staff and/or tutors may periodically alter the homework assignments. If the participant is
having difficulties completing their homework assignments or research paper(s) within the seven day time
period, due to academical reasons only, the participant may request to meet with the VIDA staff. The VIDA
staff will provide tutoring, guidance, or counseling to the participant, so he/she may successfully complete
their assignment(s). After meeting with the VIDA staff, the participant will have three days to complete their
assignment(s).
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8) MID-WEEK COUNSELING:
The VIDA participant shall wear their physical training uniform (green sweat pants, green sweat shirt, greenshorts and white VIDA tee shirt) during the midweek counseling, until the VIDA staff directs him/herotherwise. If the participant is allowed to wear civilian attire, no attire that depicts alcoholic beverages, drugs,violence, tagging, gang trends, or with sexual overtones will be allowed. Dresses or skirts shall be wornbelow the knee. Shorts and/or tank tops shall not be worn. The VIDA staff will determine what clothing is or isnot acceptable. The participant shall not bring any personal property to the counseling sessions (i.e., laptops,watches, cell phones, gaming/music/video devices, toys, etc). Contraband will be seized by the VIDA staffand returned to the participant’s parent(s) and/or legal guardian(s) at the end of the counseling session. Ifthe participant continues to bring contraband, it will be seized and returned at the end of the sixteen (16)week program. 9) IDENTIFICATION:
As directed by the VIDA staff, it is mandatory the participant obtains and have on their person, at all times, anauthorized photographic identification card. The participant is encouraged to obtain a California IdentificationCard from the Department fo Motor Vehicles. With a birth certificate and a social security number, the DMVwill issue an identification card to a minor (check with the DMV for the current fees and requirements). 10) VIOLATIONS, DISCIPLINE AND POSITIVE ACTS:
Violations: The VIDA staff will stickily enforce each of the rules. Any violation of the rules will result in the
following: The participant will be required to finish their current class and based on the totality of the
circumstances, the VIDA staff retains the discretion to either add additional hours (up to 160 hours) to the
participant’s program, recycled the participant into a future class and/or terminate the participant from the
VIDA program. The VIDA staff will also assign research papers, ranging from one (1) to ten (10) pages, to
the participant, to fully understand his/her actions and to educate the participant.
If the participant is mandated to the VIDA program by the court, probation, or detective bureau, he/she
may be subjected to criminal prosecution and/or fines based on their current case(s).
Discipline: The participant shall not graduate from the VIDA program until he/she have completed all of their
disciplinary hours and have submitted all of their homework and/or research paper(s). In many cases, the
participant will have to be recycled into a future VIDA class in order to complete all of their disciplinary hours.
Each participant must be recommended for graduation by the VIDA staff.
Positive acts: If the participant demonstrates leadership and a drive to improve himself/herself as a positive
role model, in all areas of the program, the participant may reduce their disciplinary hours. As a positive role
model and a guide to others, the participant can help us make a difference.
As a reminder, the participant’s person, property or property under the control of the participant is
subject to search at any time by any deputy sheriff or police officer as defined in chapter 4.5
(commencing with section 830) of the California Penal Code, anytime of the day or night, with or
without a warrant, as long as the participant is enrolled in the Los Angeles County Sheriff’s
Department VIDA program.
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LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES I have read, understand, and agree to obey the above listed rules: #1 though #10. Additionally, I understandif the participant violates rule #1 through #4, based on the severity of the offense and the totality of thecircumstances, the participant may be detained for a criminal investigation. If the participant has a pendingcriminal case and violates any of the rules, the court, probation, or detective bureau will be noticed of theoffense, which may result in a criminal filing.
Participant (print name): ___________________________________ Participant (signature): ____________________________________ Date: __________ Parent/legal guardian (print name): __________________________ Parent/legal guardian (signature): ___________________________ Date: __________ Parent/legal guardian (print name): __________________________ Parent/legal guardian (signature): ___________________________ Date: __________ Return this signed document to the VIDA staff during your enrollment process
LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES STATEMENT OF HEALTH FOR MINOR
EXAMINING PHYSICIAN
Each participant will be required to perform various calisthenics outlined in the President’s Fitness Challengesuch as: Marching (Close Order Drill), circuit training, sit-ups, push-ups, pull-ups, jumping jacks, leg lifts,sprinting and jogging (up to 3 miles). All the physical training is monitored by the VIDA staff. The calisthenicsare designed to educate the participant as to the importance of physical exercise and maintaining a healthylifestyle. The Center for Disease Control identified obesity in children and teenagers as a major healthconcern. In addition, the participant will be subjected to the mental stress of receiving, interpreting, and immediatelyreacting to verbal commands as they relate to physical training and marching drills. The participant willoccasionally be required to stand “at attention” for varied periods of time, not exceeding ten (10) minutes.
The purpose of this letter is to document the minor, _____________________________________________ Name of minor may or may not participate in the above listed physical training activities. Physical training is one of thecomponents of the Los Angeles County Sheriff’s Department VIDA program.
The parent(s)/legal guardian(s) were directed by the Los Angeles County Sheriff’s Department VIDA staff, tohave a physician conduct a physical examination of the above listed minor.
I, ___________________________________________________ am the above listed minor’s physician and have conducted a physical examination of said minor. I have read the above activity descriptions and haveconducted a physical examination on the above listed minor. Based on my examination of the minor, it is myprofessional opinion the minor:‘ Able to participate in the above stated physical activities.
Shall NOT participate in the above stated physical activities for the indicted reason(s):
____________________________________________________________________________________________________________ Examining physician’s signature:_______________________________________ Date:
Name of medical office: _______________________________ Physician’s address: _______________________________ LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES STATEMENT OF HEALTH FOR MINOR
PARENT’S EVALUATION
The purpose of this letter is to allow the minor, __________________________________________________ Name of minorto participate in the below listed physical training activities. Physical training is one of the components of the LosAngeles County Sheriff’s Department VIDA program.
Each participant will be required to perform various calisthenics outlined in the President’s Fitness Challengesuch as: Marching (Close Order Drill), circuit training, sit-ups, push-ups, pull-ups, jumping jacks, leg lifts, sprintingand jogging (up to 3 miles). All the physical training is monitored by the VIDA staff. The calisthenics are designedto educate the participant as to the importance of physical exercise and maintaining a healthy lifestyle. TheCenter for Disease Control identified obesity in children and teenagers as a major health concern. In addition, the participant will be subjected to the mental stress of receiving, interpreting, and immediatelyreacting to verbal commands as they relate to physical training and marching drills. The participant willoccasionally be required to stand “at attention” for varied periods of time (not exceeding 10 minutes intervals).
To the best of my knowledge, the minor is in apparent good health and is physically and mentally able to
participate in the physical training actives of the VIDA program, as described above. The participant must
receive a medical clearance letter (page 16) from a physician prior to being enrolled into the VIDA program.
I hereby represent that I have carefully read and understand the contents of this document and sign the same
of my own free will.
Parent/Legal guardian (print)____________________________________ Date:__________ Parent/Legal guardian (signature)________________________________ Date:__________ Parent/Legal guardian (print)____________________________________ Date:__________ Parent/Legal guardian (signature)________________________________ Date:__________ LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES CONSENT TO CRIMINAL HISTORY CHECK
I,____________________________________________,the parent(s)/legal guardian(s) of the minor _____________________________________________________,hereby give my written permission to Name of minor the Los Angeles County Sheriff’s Department, to conduct a criminal history check (utilizing any and all Countyand State criminal justice databases) on the above listed minor, for the purposes of enrolling the minor in theVital Intervention and Directional Alternatives Program. I understand that the purpose of the criminal historycheck is to aid VIDA staff members in determining the suitability of the minor for the program, as well as toassist staff in providing a safe and secure environment for participants and staff. I additionally authorize the Los Angeles County Sheriff’s Department to conduct periodical criminal historychecks on my son or daughter as an analytical tool to assist in measuring the success of the VIDA program. This information will be used to develop statistical reports to assist VIDA staff in the further development ofthe program. No identifying information on my son or daughter will be contained in the report.
I understand that the contents of a criminal history report are confidential and access to those reports isrestricted by California Penal Code, sections 13300. I hearby grant permission to the Los Angeles CountySheriff’s Department to share any information contained in the report with those person(s) the Departmentdeems necessary to help my child; i.e., family counselors, drug counselors, mental health professionals orany other community-based organization working with the VIDA program. This consent shall remain in effect until the minor’s eighteenth (18) birthday, or until revoked in writing by theparent/legal guardian.
I hereby represent that I have carefully read and understand the contents of this document and sign the sameof my own free will.
Parent/legal guardian (print): _________________________________ Parent/legal guardian (signature): _____________________________ Date:____________ Parent/legal guardian (print): _________________________________ Parent/legal guardian (signature): _____________________________ Date:____________ Minor (print): _____________________________________________ Minor (signature): __________________________________________ Date:____________ LOS ANGELES COUNTY SHERIFF’S DEPARTMENT VITAL INTERVENTION DIRECTIONAL ALTERNATIVES FINAL INSTRUCTIONS
The participant’s completed enrollment application must be submitted to the VIDA staff for review. It ismandatory the parent(s) and/or legal guardian(s) meet with the VIDA staff, in person, for the enrollmentinterview and assessment. Due to the fact the VIDA program is sixteen consecutive weeks, only two classesper year will be conducted.
The families with completed applications and who have submitted ALL the required documents will be
enrolled first, No exceptions!!!
Please proved the VIDA staff with the below listed documents (1 thru 5) upon your enrollment interview:
Completed enrollment application that includes: Interview application and eleven (11) signedwaivers Participant’s most recent report card or progress report Enrollment fee: “money order or cashier’s check” for $75.00 payable to: “Sheriff’s Youth
Foundation.” The enrollment fee pays for the physical training clothing, educational tours,
drug tests kits/lab fees, and the on-going support of the VIDA program. The enrollment fee is
non-refundable. Cash or a personal check will NOT be accepted.
The Statement of Health for Minor waivers (page 16 and 17) must be signed by your child’sphysician and the parent/guardian indicating the participant may participate in the physicaltraining activities of the VIDA program. Copy of the participant’s citation(s), court order, or other referral (if applicable)
Other:___________________________________________________________________________ The missing document must be submitted on or before the below list date, or your child will not
be enrolled into this class.

Source: http://vida.la/docs/forms.pdf