YMCA Youth for Youth Gambling Education Program - Contest Registration Form
Please ensure that you fill out the entire form.

You can find much more information located on our Facebook page at: https://www.facebook.com/YMCAY4Y/

Please ensure that you have read all the rules and eligibility requirements listed on that above Facebook page.

Last Name *
Your answer
First Name *
Your answer
Date of Birth *
Your answer
Email Address *
Your answer
City/Town *
Your answer
Phone Number *
Your answer
Team Entry
If you are a team, please fill out the below. If you are registering as an individual, disregard this section.
Team Name
Your answer
Team Leader (First and last name)
Your answer
How many members are on your team? (Including yourself)
Your answer
Are all team members 18-24 years of age
Terms
Please carefully read the below and acknowledge that you have met the contest requirements.
All potential actors/actresses, must be over the legal age of 18. Do you agree? *
Required
I acknowledge and agree to the rules, regulations, and eligibility requirements outlined in the "Contest Rules" package provided. *
Required
I consent that I am over the legal age of 18 and understand that misrepresenting my age will result in my immediate disqualification. *
Required
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