Youth for the Quality Care of Animals (YQCA) Training -August 10, 2019 at the Rockingham County Fairgrounds
This form is the FIRST step in completing your registration for the YQCA Training that will be held on August 10, 2019 from 5:00 - 7:00 pm at the Rockingham County Fairgrounds, 4808 South Valley PIke, Harrisonburg, VA 22801. Registration will begin at 4:30 and the training starts promptly at 5:00 pm. Once you have completed this form the next step will be sent in an email with a coupon code that you will need to enter into the YQCA portal. This code covers the cost of the training for youth participants.

If you have questions or need more information contact Sam Leech at or call 540-564-3087.

Youth for the Quality Care of Animals (YQCA) is a national multi-species quality assurance program for youth ages 8 to 21. An in-person YQCA workshop requires complete attendance. The program has been designed by extension specialists and national livestock program managers to ensure it is accurate, current and relevant to the needs of the animal industry and shows and is appropriate for youth.

Email address *
What is the youth's first name? *
Your answer
What is the youth's last name? *
Your answer
Youth birth date (MM/DD/YYYY)
Your answer
Youth age as of 12/31/2018 *
Your answer
What is the parent/guardian name? *
Your answer
Parent contact phone number *
Your answer
What county do you live in? *
Your answer
Please list any food allergies or sensitivities. Snacks/meals will not be provided but food items may be used in the educational process. *
Your answer
Please check any of the following assistive services that you may need:
For the second step of the registration you must use the YQCA portal. I understand that I must register through the YQCA portal prior to the training and if I do not utilize the YQCA portal that I will not receive my certification. *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Virginia Tech. Report Abuse - Terms of Service