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Victim Assistance, Youth Accountability (VAYA) Registration

The registration fee of $50 is non-refundable and is due at the time of registration. Fill out the below registration form and click the submit button. After submitting the form your payment will be processed securely via PayPal. Registration is not final until payment has been received in full.

Classes are held at Resolve, located at 1237 North Riverside Avenue, Suite 25, Medford, OR 97501. Jackson County Juvenile Justice will be notified upon completion of the class. If you have any questions, call 541-770-2468. 

Name of Youth (Required)
Name of Parent(s) or Guardian(s) (Required)
Best Phone to be Reached (Required)
Other phone
Mailing Address (Required)
City (Required)
State (Required)
Zip Code (Required)
Payment Type (Note: registration is not final until payment has been received in full) (R)
Verification (to make sure you're human)

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Note: Please do not include any URLs in form.