Youth Leadership Conference (YLC) & Leadership Conference Weekend Application

Please complete this form to best of your knowledge.
*
*
 
*
*
*
*

*
*
*
*
*
 
*

*
*
*
  
*
 
*
*
 
*
*
*
 
 
 
*
*
*
 
 
Emergency Contact Information
*
*
*
 
Travel Information
*
 
Medical History Questionnaire
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*
 
*