Youth Tour Delegate Form

Delegates Full Name*

First Middle Last

Preferred Name*

If your preferred name is your first name please retype your first name.

Social Security Number*

For touring purposes.

Delegate's Cell Phone Number*

Delegate's Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Date of Birth*

Shirt Size*

Parish*

Gender*

Assigned at birth.

Age*

Please enter a number from 1 to 99.

Sponsoring Cooperative*

School*

Guardian's #1 Name*

First Last

Guardian's #1 Email*

Guardian's #1 Work Phone*

Guardian's #1 Cell Phone*

Guardian's #2 Name

First Last

Guardian's #2 Email

Guardian's #2 Work Phone

Guardian's #2 Cell Phone

Delegate Photo*

Accepted file types: jpg, gif, png, Max. file size: 30 MB.

Upload a headshot of yourself for identification purposes.

Delegate's Health Insurance Card (Front)*

Max. file size: 30 MB.

Delegate's Health Insurance Card (Back)*

Max. file size: 30 MB.

Guideline Acknowledgment*

Delegate Acknowledgement

My child and I have read and understand all the guidelines and completed all of the forms.

Guideline Acknowledgement*

Parent Acknowledgement

My child and I have read and understand all the guidelines and completed all of the forms.