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Home My WebLink About472683 1 1 r I i I i i PALM DESERT YOUTH COMMITTEE APPLICATION Name Last First Middle, Home Address 4-�>- se?f--� Ean�e CA Q%A.A-1'�� C�N Street No. City State, -zip. . Telephone- A. s a Number( ) �� . � • I Email Address Grade School. ivities/C I.0 Gno bsSchool Act ��` K ��1�- 'A�� S IV rA 1\j CA I i I' Other Activities/Clubs S . I Your Personal Statement of Qualifications/Interest (continue on back .if necessary) I I j �eo -,j A-ee r- Ct C>\'e�- 40 \e- an8t e e rgp,n c- n e I '-f e e. a lee \o cc> . r, n C e ` � -�c v--� k--k 7 'D-•c--+-�j I v 4` 171 '^ S _ l Ct�Q 1 1 d PALM DESERT YOUTH COMMITTEE 3 73-510 Fred Waring Drive a Palm Desert, CA 92260 (760) 346-0611 — www.cityofpalmdesert.org �y APPLICATION NAME I�IA� C6 ADDRESS 4A39 pA�fC -A 3 Street Cit State Zip PHONE NUMBER `760 -70Z 664 `760 29 I q Home /�� Cell EMAIL ADDRESS 6-850- (z1 �� L yn ` bD -7 bb� PARENT NAME/PHONE NUMBER Cj i(( S I, Name Phone Number SCHOOL ` DGMS GRADE GRADUATION YEARW(S ACTIVITIES/CLUBS PERSONAL STATEMENT OF QUALIFICATIONS (continue on the back if necessary) V PALM DESERT YOUTH COMMITTEE APPLICATION PAGE 2 REFERENCES: Local residents who are qualified to comment on your capabilities (preferably not,a relative-or someone connected with the City of Palm Desert). Name Phone Number Relation Name Phone Number Relation APPLICATIONS,SHOULD BE RETURNED TO.:- City of Palm, Desert Deborah Schwartz Glickman 73-510 Fred Waring Drive. Palm Desert, CA 92260 IF YOU HAVE ANY.QUESTIONS REGARDING THE.YOUTH COMMITTEE, PLEASE. CALL (760) 346-0611. This application will remain on file for three years. FOR OFFICIAL' USE ONLY Date Received Date Interviewed Discussed during interview: What is the Youth Committee? ❑ . Appointed versus alternate member ❑ How to become-an appointed member ❑ Meeting schedule ❑ Meeting requirements ❑: Brown Act ❑ Subcommittees ❑ Events ❑ Communication, Letters of Recommen.dation ❑ l r - I y 0 -I' M 7 3-5 I O.FRED WARING DRIVE - ' PALM DESERT, CALIFORNIA 9 2 2 6 0=2 5 7 g TEL: 760 346-061I FAX: 760 340-0574 cityhall@ci.palm-desert.ca.us OFFICE OF THE MAYOR February 9, 2018 Mr. UmairAhmad 12 Marseilles Road Rancho Mirage,' California 92270 Dear Mr. Ahmad: It is with great pleasure that I write this letter officially notifying you that the City Council, at its regular meeting of February.8,'2018, reappointed you to the Youth Committee for a one-year term. This term will be for the period January 1, 2018, through December 31, 2018. On. behalf of the entire City Council, thank you for. your continued willingness to serve your community in this capacity. Your expertise and service have been invaluable. hope you will feel free to contact me or any member of the City Council if we can ever be of assistance to you. Sincerel SAB BY ANATHAN. MAYOR SJ:mgs cc: Deborah Glickman, Management Analyst II Janine Judy, Senior Office Assistant ;ice PRINTED ON RECYCLED PAPER I y 1 M 7 3—5 10 FRED WARING DRIVE j PALM DESERT, CALIFORNIA.9 2 2 6 0-2 5 7.8 TEL: 760 346-061I FAX: 760 340-0574 cityhall@ci.palm-desert.ca.us OFFICE OF THE MAYOR February 9, 2018 Mr. Zackary Berenbaum 73143 Ajo Lane Palm Desert, California 92260 Dear Mr. Berenbaum: It is with great-pleasure th-at I write this letter officially notifying you that the,City Council,'at its regular meeting of February 8, 2018, reappointed you to'the Youth Committee for a one-year term. This term will be for.the .period January 1, 2018, through December 31, 2018. On behalf of the entire City Council, thank- you for. your continued- willingness to serve your community-in this-capacity. Your expertise and. service have been invaluable. hope you will feel free to contact me or any member of'the City Council if we can ever be of assistance to you. Sincerely, SABBY J'ONATHAN MAYOR SJ:mgs cc: Deborah Glickman, Management Analyst II Janine Judy, Senior Office-Assistant ., *-*PRINTED ON RECYCLED PAPER 7 3—5 I o FRED_WARING DRIVE PALM DESERT, CALIFORNIA 9 2 2 60-2 5 7 8 TEL: 760 346—o6i z FAX: 76o 340-0574 cityhall@ci.palm-desert.ca.us OFFICE OF THE MAYOR February 9,'2018 Mr. Matthew Chang 77607 Barons_ Circle Palm Desert, California 92211 Dear Mr. Chang: It is with great pleasure that I write this letter officially notifying you that the City Council, at its regular meeting of February 8., '2018, reappointed you to the Youth Committee for a one-year term.'Th'is term will be for the period January 1, 2018, through December 31,.2018. On .behalf of the entire City Council,. t-hank you for your. continued willingness to serve your community in this capacity. Your expertise and. service have.been invaluable. I.hope you will feel free to contact me or any member of the City Council if we can ever be of assistance to you. Sincere SAB BY J ATHAN MAYOR SJ.:mgs cc: Deborah Glickman, Management Analyst II Janine Judy, Senior Office Assistant .; =PRINTED ON RECYCLED PAPER r - I y 0 1 PH M 7 3—5 I 0 RED W ARING DRIVE PALM DESERT, CALIFORNIA' 92 2 6 0-2 5 7 8 TEL: 760 346—O61I FAX: 760 3.40-0574 cityha11@ci.pa-1m-desert.ca.us OFFICE OF THE MAYOR February 9, 2018 Mr. Issac Cho .43487 Bordeaux Drive La Quinta, California 92253 Dear Mr. Cho: It is with great pleasure that I write this letter officially notifying.you that the City Council, at its regular meeting of February 8, 2018, reappointed you to the Youth Committee fora one-year term. This term will be for the period January 1, 2018, through December 31, 2018. On behalf of the entire City Council, thank you for your continued' willingness to serve your community in this capacity. Your expertise and service have been invaluable. I hope.you will feel free to contact me or any member of the City Council if we can.ever be of assistance to you. Sinc SAB BY J NA HAN MAYOR SJ:mgs cc: Deborah Glickman, Management Analyst II Janine Judy, Senior.Office Assistant t�t PRINTED ON RECYCLED PAPER I J 'y 0 .1 M 73-5 I o FRED WARING DRIVE PALM DESERT, CALIFORNIA 92 2 60-2 5 7 8 TEL: 76o.346—o6.I I FAX: 760 340-0574 cityha11@ci.pa1m-desert.ca.us OFFICE OF THE MAYOR February 9, 2018 Miss Patricia Da n 74260'Velard'o Street Palm Desert, California 92260 Dear Miss Dan: It is with great, pleasure that 1-write this letter officially notifying you.that the City'Council, at its regular meeting ofFebruary 8, 201-8,'reappointed you to the Youth.Committee for a one--year term. This term.will be for the period January 1, 2018, through December 31, 2018. On behalf of the entire City. Council, thank you for your continued Willingness to serve your community in this capacity. Your expertise-and service have.been invaluable: I hope you will feel free to contact Me'or any member of the City Council if we can ever be of-assistance to you. Sincerely, SABB JO HAN MAYOR SJ:mgs cc: Deborah Glickman,_Management Analyst.11 Janine Judy, Senior. Office Assistant S PRINTED ON RECYCLED PAPER -' 73-5 I O,FRED WARING DRIVE . PALM DESERT, CALIFORNIA 9 2 2 60-2 5 7 H TEL: 760 346-06 i I FAX: T60 340--0574 cityhall@ci.palm-desert.ca.us OFFICE OF THE MAYOR February 9, 2018 Mr. Timothy Fitzpatrick... .74936 Sage Drive Indian Wells, California 92210 Dear Mr. Fitzpatrick: It is with great pleasure that].write this letter officially notifying you that the City Council, at its regular meeting of February 8, .2018, reappointed you to the Youth Committee for a one-year.term. This term will be for the period January 1, 2018, through December 31, 2-018. On behalf of the- entire City Council, thank you for your continued' willingness to serve your.community in this capacity. Your expertise and service have been,invaluable. h,ope you will feel free to contact me or.any member,of the City Council if we can ever b e of assistance to you. Sincerely, SABB JO N MAYO SJ:mgs cc: :Deborah Glickman, Management Analyst]1 Janine Judy., Senior Office Assistant t r IS►0 PRINTED ON RECYCLED PAPER Illy or . po [ m 01 1 P I 7 3—5 I o FRED WARING DRIVE PALM DESERT, CALIFORNIA 9 2 2 6 0—2 5 7 8 TEL: 7 6 o 346—o6I I FAX: 760 340-0574 cityha11@6.pa1m-desert.ca.us. OFFICE OF THE MAYOR February 9, 2018 Miss Olivia Frary Post Office Box 206 Palm Desert, California 92260 Dear Miss Frary: It is with..great pleasure that I write this. Letter officially notifying you that the City Council, at its regular meeting of February 8,-2018, reappointed you to the Youth Committee for a one-year term. This term will be for the F period January ,1, 2018, through December 31, 2018. On behalf of the entire City Council, thank you for your continued willingness to serve your community in this capacity. Your expertise and service have been invaluable. hope you will feel free to contact me or any member of the City Council if we can ever be of assistance to you. Sincerely, SAB B'Y J HAN MAYOh 1 SJ:mgs cc: Deborah Glickman, Management Analyst 11 Janine Judy, Senior Office Assistant Sr0 PRINTED ON RECYCLED PAPER .11.1 'y 0. 7 3—5 I o FRED WAKING DRIVE --� PALM DESERT,..CALIFORNIA 9 2 2 60-2 5 7 8 TEL: 76o.346—o61"I FAX: 7 6 0 3 4 0-0 5 7 4- cityhall@ci.palm-desert.ca:us OFFICE OF THE MAYOR,. February-9., 2 018 Mr. Ismael Haile 73350 Calliandra Street Palm Desert., California 92260 Dear Mr.'Haile: It is with great pleasure that I write this Jetterofficially notifying you that the City,Council, at its regular meeting.of February 8, 2018, reappointed you•to the Youth Committee for a one-year.term. This term will be for the ,-� period January'1, 2018, through December 3.1, 20.18. On behalf of the entire City Council, thank, you for your continued willingness to serve your community in this capacity. Your expertise and service have been.invaluable. hope you will,feel free to contact me or any member of theCity Council if we can ever be of assistance to you. Sincerely, SAB BY NATHAN MAYOR \ SJ:mgs cc: Deborah Glickman, Management Analyst 1.1 Janine Judy, Senior Office Assistant ram«PRINTED ON RECYCLED PAPER a,t 1. 1 y 7 3—5 I o FRED WARING DRIVE PALM DESERT, CALIFORNIA 9 2 2 60-2 5 7 S TEL: 760 346-061I FAX: 760 340-0574 ciryha11@ci.pa1m-desert.,ca.us OFFICE OF THE MAYOR February 9, 2018 Miss Tacie Johnson 43730 Buena Circle Palm Desert, California 92260 Dear Miss Johnson: It is with great pleasure that I write this Fetter officially notifying yingyou that the City Council, at its regular meeting of February 8, 2018, reappointed you to the Youth Committee fora one-year term. This term will be for the r period January 1, 2018, through December 31, 2018. On behalf of the 'entire City Council, thank you for your continued .willingness to serve your community in this capacity. Your,-expertise and service have been invaluable.. I hope you will feel free to contact me or any member of the CityCouncil if we can,ever be of assistance to you. Sincerely, .SAB BY NA AN MAYOR SJ:mgs cc: Deborah Glickman, Management Analyst II Janine Judy, Senior'Office Assistant. �* `PRINTED ON RECYCLED PAPER I M: 7 3-5 I.0 FRED WARING DRIVE -� PALM',DESERT, CALIFORNIA 92 2 60-2 5 7 8 TEL: 760 346-06 i I FAX: 76o 340-0574 cityha11@ci.palm-desert.ea.us OFFICE OF THE MAYOR February,9, 2018 Miss. Claire Kim 42071 Verdin Lane Palm Desert, California 92260 Dear Miss Kim: It is.with great pleasure that 1 write this letter officially-notifying you that the City Council, at its.regular meeting'of February 8., 20187 reappointed you.to the Youth-Committee-for a one-year term_: This term will be for the ' �- period January 1, 2018, through December 31, 2018. On behalf of the entire City Council, thank you for' your continued willingness to ServQ.your community in this Capacity. Your expertise and service have been invaluable: hope you will feel.free to contact me or any member of the. City Council if we can ever be of assistance to you'. - Sincerely, SABBY.- ONATHAN MAYOR SJ:mgs cc: Deborah Glickman, Management Analyst II Janine Judy, Senior Office.Assistant IP0 PRINTED.CIN RECYCLED PAPER I I y 0 M 7 3-5 r o FRED WARING DRIVE f--, PALM DESERT, CALIFORNIA 9 2 2 60-2 5 7 8 TEL: 760 346-061I FAX: 760 340-0574 cityhall@ci.palm-desert.ca.us OFFICE OF THE MAYOR February 9, 2018 Miss Lily Kim 44 Sutton Place East Palm Desert, California 92211 Dear Miss Kim: -It is with great pleasure that 1write this letter,officially notifying you that the City Council, at its regular meeting of February 8, '2018,' reappointed you to the Youth Committee for a one-year term. This term will be.for the period January 1, 2018, through December 31, 2018. On behalf of the entire City-Council, thank you for your continued willingness to serve your community in this capacity. Your expertise and service have been invaluable. hope you will feel free to contact me or any member of the City Council if we can ever be of assistance to you. Sincerely, SABBY J NATHAN MAYOR SJ:mgs cc: Deborah Glickman, Management Analyst 11 Janine Judy, Senior Office Assistant 'sue PRINTED ON RECYCLED PAPER I I,- y -0 1. M 37-5 10 FRED WARING DRIVE PALM DESERT, CALIFORNIA 9 2 2'60-2 5 7.S i TEL: .760 34.6—O61.I. FAX: 760 340-0.5 7.4 cityha11@ci.palm-desert.ca.us OFFICE OF THE MAYOR , February 9, 2018 Mr. Tazz Ross 29688 Calle Colina Cathedral .City, California 92234 Dear Mr. Ross: It is with great pleasure that I write this letter officially g notif in you.that• Y the-City Council, at its regular meeting of February_8, 2018, reappointed you to the'Youth Committee'for a one-year term:"This term will be for the period January 1, 2018, through December 31, 201 8. On behalf of -the entire City Council; thank you. for, .your continued- willingness to serve your community in.-this capacity. Your expertise and service have been invaluable. - hope yo.0 will feel free to contact me or any member of the city Council if-we can ever be of assistance to you. Sincerely, SAB BY . NATHAN MAYO SJ:mgs cc: -Deborah..Glickman, Management Analyst 11 Janine Judy, Senior Office Assistant J` • fu„PRINTED ON RECYCLED PAPER' Y -I. ,Y: 01- 1. P '0- 73-5 I O FRED WARING.DRIVE . PALM DESERT, CALIFORNIA.9 2 60-2578 TEL: 76o 346-,o61 I FAX: 76o 340-0574 Cityhall@ci.palm-desert.',c.a..us OFFICE OF THE MAYOR February 9, 2.01$�- Miss Jennifer Schwartz 45305 Blackfoot.Way Indian Wells, California 92201 Dear-Miss Schwartz: It is with great pleasure that I write this letter-officially notifying ingyou that the City Council, at its regular meeting of February 8, 2018, reappointed you to the Youth Committee for a.one-Y ear term: This,term will be for the .. period January 1, 2018, through December 3.1, 2018. On behalf of the entire City Council, thank'' you for your continued willingness to serve your community in this capacity. Your expertise and p service have been invaluable. hope you will feel free to contact me or any member,of the City Council if we can ever be of assistance to you.' Sincerely, SABBY J. NATHAN MAYOR' SJ:rags: cc.: Deborah Glickman, Management Analyst 11 Janine Judy,.Senior Office Assistant It PRINTED ON RECYCLED PAPER 73-5 I O FRED WARING DRIVE PALM DESERT, CALIFORNIA 9 2 2 6 O—2'.5.7 8 TEL: 760 346—O61I FAX: 760, 3.4.0-0574 cityha11@c1.pa1m-desert.ca.us OFFICE OF THE MAYOR February 9, 20.18 Mr. Uriah Shaw 44-430 San Rafael Avenue Palm Desert, California 9226.0 Dear Mr. Shaw: It is with, great pleasure that I write this letter officially notifying in you that gY , the City Council; at its regular meeting of February,87 20187 reappointed you to the Youth Committee for a one-year term. This term will be for the period January 1 2018, through December 31, 2018. On behalf of the entire City Pouncil,_thank you 'for your continued willingness.to serve your community in this capacity. Your expertise and service have been invaluable. hope you will feel free to contact,me.or any member of the City Coun'c,il if.we can ever be of assistance to you. S* c-e-re ty, Y , SABB JONATHAN MAYOR SJ:mgs cc: Deborah. Glickman, Management Analyst II Janine Judy, Senior Office Assistant ' 1.PRINTED ON RECYCLED PAPER 5. 1 y 0 2 7 3--5 I O FRED WARING DRIVE PALM DESERT, CALIFORNIA 9 2 2 60-2-5 7 8 TEL: 760 346-061I FAX: 760 340-0574 cityha11@ci.pa1m-desert.ca.us OFFICE OF THE MAYOR February 9, 2018 Miss Daria Wood 49 Payson Circle Palm Desert, California 92211 Dear Miss Wood It is with great pleasure that I write this letter officially notifying you that the City Council, at its regular meeting of February 8, 2018, reappointed you to the Youth Committee for a.one-year term. This term will be for the period January 1, 2018, through December 311 2.018. On behalf. of the entire City Council, thank you for your continued .willingness to serve your community in this capacity. Your expertise and service have been invaluable. hope you will feel free to contact me-or any member of the City Council if we can ever be of assistance to you. Si c' ely, SABBY J NATHAN MAYOR SJ:mgs cc: Deborah .Glickman, Management Analyst II Janine Judy, Senior Office.Assistant *ems PRINTED ON RECYCLED PAPER STAFF REPORT CITY OF PALM DESERT DEPARTMENT OF COMMUNITY DEVELOPMENT MEETING DATE: June 28, 2018 PREPARED BY: Deborah S. Glickman, Management.Analyst REQUEST: Accept the resignation of ten (10) Palm Desert Youth Committee members and"appoint eight (8) new members to the -Palm Desert Youth Committee. Recommendation By-Minute Motion: 1. Accept the resignation of Palm De'sert ' Youth Committee members Matthew Chang, Isaac Cho, Patricia Dan, Olivia Frary, Tacie Johnson, .,..,.Clare Kim, Tazz Ross, Jenny Schwartz, U riah Shaw, and Daria Wood, and; 2. Appoint Marco Capobianco, Alan Cho, Hailey Dewegeli, Savannah f Duckworth, Erin Kulas, Teana Ross, Jacqueline Scibona, and Todd Shaw to the Palm Desert Youth Committee. Strategic Plan Objective The Palm Desert Youth Committee assists with the Economic Development goal of expanding quality education so that. our youth are prepared for the workplace of the future. It also assists with the Education goal -of creating community awareness of, and support for,, the building blocks of student success, including academic, vocational, and career. success. Background Analysis As a result of their graduation from high school, ten (10) appointed Palm Desert Youth Committee members have given a written or verbal resignation from the Committee. Consequently, the Committee now has ten (10) vacancies. Staff is proposing that the vacancies be filled -by Marco Capobianco, Alan Cho, Hailey- Dewegeli, Savannah Duckworth, Erin Kulas, Teana Ross, Jacqueline Scibona, ,and Todd Shaw, all of whom are already serving on the Committee as alternates. Staff Report Youth Committee Resignations and Appointments Page 2 of 2 June 28, 2018 Fiscal Analysis There is no fiscal impact related to this request,'. LEGAL REVIEW DEPT. REVIEW FINANCIAL ' CITY MANAGER REVIEW N/A N/A, Robert W. Ryan Stendell Janet Moore Lauri A laian Hargreaves Director of Director of Finance City Manager City Attorney Community Development ATTACHMENTS: Letters of resignation from Matthew Chan Isaac Cho Patricia g g, , Dan, Tacie Johnson, Clare Kim, Uriah Shaw, and Daria Wood PALM DESERT YOUTH COMMITTEE 73-510 Fred Waring Drive ~ I`. Palm Desert, CA 92260 (760).346-0611 -www.cityofpalmdesert.org` APPLICATION NAME ,w NX I , ADDRESSAl p ITA S`V et City State Zip PHONE NUMBER Homel Cell EMAIL ADDREc� PARENT NAME/PHONE NUMBER Name Phone Number SCHOOL Ar I A#Ar GRADE GRADUATION YEAR .ACTIVITIES/CLUBS PERSONAL STATEMENT OF QUALIFICATIONS (continue on the back if necessary). y 1 a. I Jake Murphy,Application for Palm Desert Youth Committee: Activities/Clubs: P DSC and FCA Soccer Club, 2015-2018 PDYSA Baseball Team,2010-2015 Personal Soccer Trainer, 2018 Personal Statement'of Qualifications: I believe I am qualified for the Palm Desert Youth Committee because, one; I did community service projects with Sacred Heart School totaling 81 hours of service. I have volunteered with the Narrow Door, Find Food Bank, and numerous other organizations dedicated'to supporting people affected by cancer,autism,down syndrome and-economic difficulty.Second, I am very interested in the organization and government of.the community that I live in. I look forward to being a part of my city through this committee. Third, I am very dedicated to pursuing new opportunities that interest me. For example,.for the past three and a half years I-have been striving to become a better soccer player through personal training arid joining higher level teams..I also strive-to improve academically through private tutoring and summer programs to take advanced classes .in high school. lastly, as an incoming freshman to Xavier College Prep, I would like to maintain and improve Xavier's representation and reputation in the committee. - 1 PALM DESERT YOUTH COMMITTEE APPLICATION � PAGE 2 REFERENCES: Local residents who are qualified to comment on your capabilities ( (preferably not a relative or someone connected with.the City of Palm Desert). ah Name Phone Number Relation Kiaf+o di.Sj Name Phone umber_- )k -J( Relation APPLICATIONS SHOULD BE RETURNED TO: City of Palm Desert 73-510 Fred Waring Drive Palm Desert, CA 92260 IF YOU HAVE ANY QUESTIONS REGARDING THE YOUTH COMMITTEE, PLEASE CALL (760) 346-0611. This application will remain on file for three years. FOR.OFFICIAL USE ONLY, Date Received Date Interviewed Discussed during interview: What is the Youth Committee? ❑ Appointed versus alternate member ❑ How to become an appointed member ❑ Meeting schedule ❑ Meeting requirements ❑ Brown Act � ❑ Subcommittees. ❑ Events ❑ Communication ❑ Letters of Recommendation ❑ PALM DESERT YOUTH COMMITTEE Y ' 73-510 Fred Waring Drive Palm Desert, CA 9226.0 760 346-0611 —www.cit of almdesert.or ( ) v p q CITY OF PALM DESERT—VOLUNTEER PROGRAM ACKNOWLEDGEMENT OF WORKERS' COMPENSATION 1-hereby acknowledge that as a volunteer for the City of Palm Desert(City) in the capacity of.the Palm Desert Youth Committee, i am not an employee of the City, but that I am covered under the City's workers' compensation plan since the City•has adopted a resolution extending workers' compensation coverage to certain volunteers in specified categories pursuant to Labor Code Section 3363.5. As a volunteer who is covered under the City's'workers'compensation plan, I expressly agree and acknowledge that workers' compensation is my exclusive remedy for any injury suffered while performing said volunteer duties, and that I cannot and will not seek to bring any other claim or actions of any type whatsoever against the City, its employees, officers, agencies, other volunteers and officials. Date. OppSignature: rant Name: Q- Pa a or Gu rdi n Si nature (i inor): 1 Witness: t, r �1 �~ PALM DESERT YOUTH COMMITTEE i� 73-510 Fred Waring Drive Palm Desert, CA 92260 (760),346-06111 —www.cityofpal.mdesert.org CITY OF PALM DESERT. GENERAL TRAVEL AUTHORIZATION/RELEASE .1 give permission for my child, = , who is under the age of 18, to travel in a vehicle or on public transports ion for the following reason(s): Transportation to and from Palm Desert Youth Committee activities I agree to hold the City of Palm Desert, its elected or appointed officers, agents, officials, employees', and volunteers harmless from any and all claims, demands,. actions, or suits arising*out of or in connection with the above. Parent/Legal Guardian's signature denotes acceptance of the terms of this permission to transport. J r' Parent/Legal Guardian HLAq >1 Name Phone No. -T )-Ark- Z:L, ddress City/State Zip Code K AK ly lignYure Date f Emergency Contact Information J i Name Phone No. Name Phone No. GIIY 01 P H [ M OESERI 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92260-2578 TEL: 760 346-061 E FAX: 760 340-0574 ciryhall@ci.palm-desen.ca.us OFFICE OF THE MAYOR July 27, 2018 Mr. Matthew Chang 77607 Barons Circle Palm Desert, California 92211 Dear Mr. Chang: At its regular meeting of June 28, 2018, Palm Desert City Council accepted your resignation from the Youth Committee with very sincere regret. We thank you for taking the time to serve your community. On behalf of the citizens of Palm Desert, the City Council would like to wish you well on all your future endeavors. We all know the extra effort it takes to be involved in civic affairs, and your service to this board has been very much appreciated. I hope you will not hesitate to call on us if we can ever be of service to you. Sinc ly, SABBY JO HAN MAYOR SJ:glr cc: Deborah Schwartz Glickman, Management Analyst II Janine Judy, Management Specialist I lily Of PHIM DESERT 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92260-2578 TEL: 760 346-o6iI FAX: 760 340-0574 cityha11@cTpa1m-deserc.ca.us OFFICE OF THE MAYOR July 27, 2018 Mr. Issac Cho 43487 Bordeaux Drive La Quinta, California 92253 Dear Mr. Cho: At its regular meeting of June 28, 2018, Palm Desert City Council accepted your resignation from the Youth Committee with very sincere regret. We thank you for taking the time to serve your community. On behalf of the citizens of Palm Desert, the City Council would like to wish you well on all your future endeavors. We all know the extra effort it takes to be involved in civic affairs, and your service to this board has been very much appreciated. I hope you will not hesitate to call on us if we can ever be of service to you. S�erety 4SABBYTHAN SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I CITY 01 PHIM DESERT 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92 2 60-2 5 7 8 TEL: 760 346—o6xi FAx: 76o 340-0574 ciEyhaII@ci.pa]m-desea.ca.us OFFICE OF THE MAYOR July 27, 2018 Miss Patricia Dan 74260 Velardo Street Palm Desert, California 92260 Dear Miss Dan: At its regular meeting of June 28, 2018, Palm Desert City Council accepted your resignation from the Youth Committee with very sincere regret. We thank you for taking the time to serve your community. On behalf of the citizens of Palm Desert, the City Council would like to wish you well on all your future endeavors. We all know the extra effort it takes to be involved in civic affairs, and Your service to this board has been very much appreciated. I hope you will not hesitate to call on us if we can ever be of service to you. Since SABB O T MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I CIIV 01 P 0 [ DESERT 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92 2 60-2 5 7 8 TEL: 760 346-o6iz FAX: 760 340-0574 ciryhall@ei.palm-deserr.caxs OFFICE OF THE MAYOR July 27, 2018 Miss Olivia Frary Post Office Box 206 Palm Desert, California 92260 Dear Miss Frary: At its regular meeting of June 28, 2018, Palm Desert City Council accepted your resignation from the Youth Committee with very sincere regret. We thank you for taking the time to serve your community. On behalf of the citizens of Palm Desert, the City Council would like to wish you well on all your future endeavors. We all know the extra effort it takes to be involved in civic affairs, and your service to this board has been very much appreciated. I hope you will not hesitate to call on us if we can ever be of service to you. Sinc re SABBYJO THAN MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I CIIY Of PHIM 01 1 P I 73-5i0 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92 2 60-2 578 TEL: 760 346—o6:I FAX: 76o 340-0574 cityhall@ci.palm-deserr.ca-w OFFICE OF THE MAYOR July 27, 2018 Miss Tacie Johnson 43730 Buena Circle Palm Desert, California 92280 Dear Miss Johnson: At its regular meeting of June 28, 2018, Palm Desert City Council accepted your resignation from the Youth Committee with very sincere regret. We thank you for taking the time to serve your community. On behalf of the citizens of Palm Desert, the City Council would like to wish you well on all your future endeavors. We all know the extra effort it takes to be involved in civic affairs, and your service to this board has been very much appreciated. I hope you will not hesitate to call on us if we can ever be of service to you. Sin4ely" SAAN MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I CITY 0 [ PH [ M OESERI 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92 2 60-2 578 TEL: 760 346—o6E1 FAX: 760 340-0574 aryhall0d.palm-deserr,ca.us OFFICE OF THE MAYOR July 27, 2018 Miss Claire Kim 42071 Verdin Lane Palm Desert, California 92260 Dear Miss Kim: At its regular meeting of June 28, 2018, Palm Desert City Council accepted your resignation from the Youth Committee with very sincere regret. We thank you for taking the time to serve your community. On behalf of the citizens of Palm Desert, the City Council would like to wish you well on all your future endeavors. We all know the extra effort it takes to be involved in civic affairs, and your service to this board has been very much appreciated. I hope you will not hesitate to call on us if we can ever be of service to you. Si cerely, SABBY JOPTHAN MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I CIIV 01 P 0 1 M 01 1 N I 73-510 PRED WARING DRIVE PALM DESERT, CALIFORNIA 92260-2578 TEL: 760 346—o6Fi FAX: 760 340-0574 cityhaU@ci.pa1m-dcscrt.ca.us OFFICE OF THE MAYOR July 27, 2018 Mr. Tazz Ross 29688 Calle Colina Cathedral City, California 92234 Dear Mr. Ross: At its regular meeting of June 28, 2018, Palm Desert City Council accepted your resignation from the Youth Committee with very sincere regret. We thank you for taking the time to serve your community. On behalf of the citizens of Palm Desert, the City Council would like to wish you well on all your future endeavors. We all know the extra effort it takes to be involved in civic affairs, and your service to this board has been very much appreciated. I hope you will not hesitate to call on us if we can ever be of service to you. Sinc SABBY JO IHAN MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I CITY 01 PHIM NMI 73-510 FRED WARING DRIVE PALM DESERT CALIFORNIA 92260-2578 TEL: 760 346-o6E E FAX: 760 340-0574 nvyha11@a.paIm-desert.ca.us OFFICE OF THE MAYOR July 27, 2018 Miss Jennifer Schwartz 45305 Blackfoot Way Indian Wells, California 92201 Dear Miss Schwartz: At its regular meeting of June 28, 2018, Palm Desert City Council accepted your resignation from the Youth Committee with very sincere regret. We thank you for taking the time to serve your community. On behalf of the citizens of Palm Desert, the City Council would like to wish you well on all your future endeavors. We all know the extra effort it takes to be involved in civic affairs, and your service to this board has been very much appreciated. I hope you will not hesitate to call on us if we can ever be of service to you. Sin sly, SABBYJON THAN MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I Lily RF rRt (Il DESERT 73-51 O FRED WARING DRIVE PALM DESERT,CALIFORNIA 92260-2578 TEL: 760 346-061I FAx: 760 340-0574 ciryhall@d.palm-desrrr.mus OFFICE OF THE MAYOR July 27, 2018 Mr. Uriah Shaw 44-430 San Rafael Avenue Palm Desert, California 92260 Dear Mr. Shaw: At its regular meeting of June 28, 2018, Palm Desert City Council accepted your resignation from the Youth Committee with very sincere regret. We thank you for taking the time to serve your community. On behalf of the citizens of Palm Desert, the City Council would like to wish you well on all your future endeavors. We all know the extra effort it takes to be involved in civic affairs, and your service to this board has been very much appreciated. I hope you will not hesitate to call on us if we can ever be of service to you. Sincerely, SABBYJONA HAN MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I City 01 PUM OMNI 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92260-2578 TEL: 760 346—o6u FAX: 760 340-0574 dtyhall@d.palm-dcwt.m us OFFICE OF THE MAYOR July 27, 20188 Miss Daria Wood 49 Payson Circle Palm Desert, California 92211 Dear Miss Wood: At its regular meeting of June 28, 2018, Palm Desert City Council accepted your resignation from the Youth Committee with very sincere regret. We thank you for taking the time to serve your community. On behalf of the citizens of Palm Desert, the City Council would like to wish you well on all your future endeavors. We all know the extra effort it takes to be involved in civic affairs, and your service to this board has been very much appreciated. I hope you will not hesitate to call on us if we can ever be of service to you. Sincerely, SABBY JONAT N MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I Oily DF PHIM DESERT ffl;�Wpl' 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92260-2578 TEL: 760 34.6—o6i1 FAX: 760 340-0574 cicyha11 ci.palm-dcserr.ca.us OFFICE OF TAE MAYOR July 27, 2018 Mr. Marco Capobianco 16 Via Montagna Rancho Mirage, California 92270 Dear Mr. Capobianco: It is with great pleasure that I write this letter officially notifying you that the City Council, at its regular meeting of June 28, 2018, appointed you to the Palm Desert Youth Committee to fill the vacant position. Therefore, your term will run through December 31, 2018, at which time you will be eligible for reappointment. On behalf of the City Council, thank you for your willingness to serve your community. We know that your talents will be very valuable to the Palm Desert Youth Committee, which is scheduled to meet next on Monday, September 10, 2018, at 6:00 p.m. I hope you will feel free to contact me or any member of the City Council if we can ever be of assistance to you. Sincer �I SABBYJONA - AN MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I CIIY Of PR1M 0ESERI 73-5I O FRED WARING DRIVE PALM DESERT, CALIFORNIA 92 2 60-2 5 7 8 TEL: 760 346—o6LI FAX: 760 340-0574 c!tyha11@ci.pa1m-descrt.ca.us OFFICE OF THE MAYOR July 27, 2018 Mr. Alan Cho 43630 Parkway Esplanade E La Quinta, California 92253 Dear Mr. Cho: It is with great pleasure that I write this letter officially notifying you that the City Council, at its regular meeting of June 28, 2018, appointed you to the Palm Desert Youth Committee to fill the vacant position. Therefore, your term will run through December 31, 2018, at which time you will be eligible for reappointment. On behalf of the City Council, thank you for your willingness to serve your community. We know that your talents will be very valuable to the Palm Desert Youth Committee, which is scheduled to meet next on Monday, September 10, 2018, at 6:00 p.m. I hope you will feel free to contact me or any member of the City Council if we can ever be of assistance to you. Sincer SABBYJONATHAN MAYOR SB:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I CIIY DF P H [ M DESERT 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92260-2578 TEL: 760 346-o6u FAX: 760 340-0574 ciryU1@d.pa1m-dcscrt.ca.us OFFICE OF THE MAYOR July 27, 2018 Miss Hailey Dewegeli 82902 Vincent Drive Indio, California 92201 Dear Miss. Dewegeli: It is with great pleasure that I write this letter officially notifying you that the City Council, at its regular meeting of June 28, 2018, appointed you to the Palm Desert Youth Committee to fill the vacant position. Therefore, your term will run through December 31, 2018, at which time you will be eligible for reappointment. On behalf of the City Council, thank you for your willingness to serve your community. We know that your talents will be very valuable to the Palm Desert Youth Committee, which is scheduled to meet next on Monday, September 10, 2018, at 6:00 p.m. I hope you will feel free to contact me or any member of the City Council if we can ever be of assistance to you. Sincerely, SABBYJONAT N MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I CIIV OE PHIIO OESER � 73-510 FRED WARING DRIVE - PALM DESERT, CALIFORNIA 92260-2578 TEL: 760 346—o6rE - FAx: 760 340-0574 ciryhall@ci,pal m-desert.ca.w OFFICE OF THE MAYOR July 27, 2018 Miss Savanna Duckworth 43629 Parkway Esplanade W La Quinta, California 92210 Dear Miss. Duckworth: It is with great pleasure that I write this letter officially notifying you that the City Council, at its regular meeting of June 28, 2018, appointed you to the Palm Desert Youth Committee to fill the vacant position. Therefore, your term will run through December 31, 2018, at which time you will be eligible for reappointment. On behalf of the City Council, thank you for your willingness to serve your community. We know that your talents will be very valuable to the Palm Desert Youth Committee, which is scheduled to meet next on Monday, September 10, 2018, at 6:00 p.m. I hope you will feel free to contact me or any member of the City Council if we can ever be of assistance to you. Sincerely, SABBYJONA HAN MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I Lily Uf PRA DESERT 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92260-2578 TEL: 760 346—o6Lx FAX: 760 340-0574 ciryha11@ci.pa1m-deserr.ca.w OFFICE OF THE MAYOR July 27, 2018 Miss Erin Kulas 45365 Desert Eagle Court La Ouinta, California 92253 Dear Miss. Kulas: It is with great pleasure that I write this letter officially notifying you that the City Council, at its regular meeting of June 28, 2018, appointed you to the Palm Desert Youth Committee to fill the vacant position. Therefore, your term will run through December 31, 2018, at which time you will be eligible for reappointment. On behalf of the City Council, thank you for your willingness to serve your community. We know that your talents will be very valuable to the Palm Desert Youth Committee, which is scheduled to meet next on Monday, September 10, 2018, at 6:00 p.m. I hope you will feel free to contact me or any member of the City Council if we can ever be of assistance to you. Sincerely, -- Jc;:�- SA HAN MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I CITY F PRIM DESERT 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92 2 60-2 5 7 8 TEL: 760 346—o611 FAX: 760 340-0574 c i ryha119ci.p alm-des e a.ca.us OFFICE OF THE MAYOR July 27, 2018 Miss Teana Ross 29688 Calle Colina Cathedral City, California 92234 Dear Miss. Ross: It is with great pleasure that I write this letter officially notifying you that the City Council, at its regular meeting of June 28, 2018, appointed you to the Palm Desert Youth Committee to fill the vacant position. Therefore, your term will run through December 31, 2018, at which time you will be eligible for reappointment. On behalf of the City Council, thank you for your willingness to serve your community. We know that your talents will be very valuable to the Palm Desert Youth Committee, which is scheduled to meet next on Monday, September 10, 2018, at 6:00 p.m. I hope you will feel free to contact me or any member of the City Council if we can ever be of assistance to you. Sincerely, SABBYJON HAN MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I lIY OE PDE �I DESERT 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92 2 60-2 5 7 8 TEL: 760 346-o61I FAX: 760 340-0574 cityhall@d,palm-dcsat.ca.us OFFICE OF THE MAYOR July 27, 2018 Miss Jacqueline Scibona 74785 San Cristoval Circle Palm Desert, California 92270 Dear Miss. Scibona: It is with great pleasure that I write this letter officially notifying you that the City Council, at its regular meeting of June 28, 2018, appointed you to the Palm Desert Youth Committee to fill the vacant position. Therefore, your term will run through December 31, 2018, at which time you will be eligible for reappointment. On behalf of the City Council, thank you for your willingness to serve your community. We know that your talents will be very valuable to the Palm Desert Youth Committee, which is scheduled to meet next on Monday, September 10, 2018, at 6:00 p.m. I hope you will feel free to contact me or any member of the City Council if we can ever be of assistance to you. Sincerely, SABBYJ THAN MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I Allik CIIV Of PH [ M DESERT 73-510 FRED WARING DRIVE PALM DESERT, CALIFORNIA 92260-2578 TEL: 760 346—o61 I FAX: 760 340-0574 cityhall@6.palm-desert.ca.us OFFICE OF THE MAYOR July 27, 2018 Mr. Todd Shaw 44430 San Rafael Ave Palm Desert, California 92260 Dear Mr. Shaw: It is with great pleasure that I write this letter officially notifying you that the City Council, at its regular meeting of June 28, 2018, appointed you to the Palm Desert Youth Committee to fill the vacant position. Therefore, your term will run through December 31, 2018, at which time you will be eligible for reappointment. On behalf of the City Council, thank you for your willingness to serve your community. We know that your talents will be very valuable to the Palm Desert Youth Committee, which is scheduled to meet next on Monday, September 10, 2018, at 6:00 p.m. I hope you will feel free to contact me or any member of the City Council if we can ever be of assistance to you. Sincerely, SABBYJON THAN MAYOR SJ:glr cc: Deborah S. Glickman, Management Analyst II Janine Judy, Management Specialist I PALM DESERT.'YOUTH COMMITTEE APPLICATION PAGE 2 The undersigned hereby authorizes .the City of Palm Desert staff to inform any licensed physician/surgeon/dentist to proceed. with any. medical treatment as seen fit or, prescribed 'b a licensed h sician/sur eon/dentist to the minor p Y pY g -f named below. Any expenses and related costs generated by these treatments, medications, x- rays, anesthetics, or procedures shall be paid by the undersigned. 1 ACKNOWLEDGE THAT I.HAVE READ THE FOREGOING and,that I am aware of the i legal consequences of this agreement, including that it prevents me from suing the City of Palm Desert, .its elected or appointed, ':officials,- officers, agents, employees, . or volunteers if. I am injured or.damaged. for any reason as a result of participation in this activity. I further acknowledge that no oral representations, 'statements or inducements have been made. IF THE PARTICIPANT IS A MINOR, HIS OR HER-CUSTODIAL PARENT OR LEGAL GUARDIAN MUST READ AND EXECUTE THIS, AGREEMENT. I HEREBY WARRANT THAT I AM THE.CUSTODIAL PARENT OR LEGAL-GUARDIAN OF JII (PRINt PARTICIPANT'S FULL NAME) WHO,IS A MINOR, ON MY-OWN AND SAID MINOR'S BEHALF TO THE TERMS.AND CONDITIONS OF THE FOREGOING AGREEMENT. , i f Participant o'r Parent/Guardian (print) Signature Date. � Wol Home Address: �.-! be�l 5 Z 1ntf �� _, als,e Street J City ...... :.:.:...: :...: ::. :: :.. : : .. :::.::::::.:::.:::.::.::.:::.::.:::.:. .: '. :I:. :::P:::o:: : ::: I .. .n. Ph Worl ..Ph. n.. ::::.:::::.::::.:::::::.::::::M:o ...e....... ............ Re .. H .rr .......... .......................... .................. .. a ...... .. t... t.................... . . 0 S 1A 3 3 (1'� LIkolb)NI-45Lk\ 10 o) b 1