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 [email protected] 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, [email protected] or Steve Henness, 573-884-6618, [email protected] 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!