Preferred Name on your name tag? (Make sure it is spelled how you want it!)
Your answer
Date of Birth *
MM
/
DD
/
YYYY
School classification for the 2022-2023 school year *
Do you have plant identification/range competition experience? If so, how much? *
Explain your involvement in range or plant related competitions (FFA/4-H), Wildlife or Outdoor Activities (Hunting, Farming, etc), or any other relevant experience you may have. *
Your answer
Male/Female *
Participant T-Shirt Size *
Street Address *
Your answer
City *
Your answer
State *
Zip *
Your answer
County *
Your answer
Participant Email Address *
Your answer
Participant Cell Phone Number *
Format: XXX-XXX-XXXX
Your answer
First and Last name of Parent(s) *
Your answer
Parent Email Address *
Your answer
Additional Parent Email Address (Optional)
Your answer
Parent Cell Phone Number *
Your answer
Name of Extension Agent, Teacher, or Advisor *
Your answer
Email of Extension Agent, Teacher, or Advisor *
Your answer
Sponsor Group/Organization (this is the group providing funding for you to attend the workshop, if known)
Your answer
Email of Sponsor Group/Organization Representative
Your answer
Do you have any food allergies or any other health issues we should know about? Explaining clearly (certain foods, insect bites/stings, severity, etc.) will enable us to make any arrangements or take any precautions to ensure a safe experience for everyone!
Your answer
If accepted to attend the YRW, do you understand that you must send payment or make arrangements to do so by May 15, 2023?Please look on our website for info about finding a sponsor.
Checks should be made out to "TSSRM Youth Range Workshop" and must be mailed to:
Attn: Ryan Kennedy
Youth Range Workshop
1404 N Big Spring St PMB 218
Midland, TX 79701
For credit/debit card payment we will email information to selected campers.