Missouri Youth Civic Leaders Summit
March 4-6, 2016
Team Planning Form
4-H Staff / Participating MCB Youth Groups / Coordinating Group Leaders:
Please use this form to keep track of youth/adult members registering to attend YCLS as
a team. Send copy of Team Planning Form to gracesk@missouri.edu by Feb. 1, 2016.
Event Details, Instructions, and Online Registration are located at:
http://4h.missouri.edu/ycls/main
For team registration help, please contact: Sherry Grace, 573-882-9360,
gracesk@missouri.edu or Steve Henness, 573-884-6618, hennesss@missouri.edu
County/Community:
Group Name:
Youth Team Members:
Age
Gender
Names
(minimum 2 youth ages 14-18)
Special Needs
(if any)
Fees/Pymt
(Check or
Credit Card)
1.
$
2.
$
3.
$
4.
$
5.
$
6.
$
7.
$
8.
$
Adult Team Members:
Chaperone
(Age 21+)
Gender
Names
(minimum 1 adult, first registration
complimentary)
Adult Background
Consent Form
(LG639) by Feb. 15?
Fees/Pymt
(Check or
Credit Card)
Yes / No
1.
$
Yes / No
2.
$
Total Registration Fees:
$
Thanks for all you do for Missouri youth!