Liberty Youth Council Registration
Event Timing: 2019 - 2020
Event Address: Liberty Town Hall - 239 S Fayetteville St. Liberty, 27298
Contact us at 336.880.0537 cell or
Student Name (First and Last)
PROVIDENCE GROVE HS
EASTERN RANDOLPH HS
Parent's Names (Primary Parent or both)
Parent's Contact Information (email or Cell) for Permission
Student's T-Shirt Size (Adult Sizes)
Current Grade Point Average (2018-2019 school year)
Liberty Youth Council Terms & Conditions
I have read the terms and conditions of the Liberty Youth Council and agree to abide by it. I understand that the Liberty Youth Council will require my participation in meetings, trainings, and service learning activities. I understand that if I am granted into the Liberty Youth Council I will have to complete at least 30 community service hours. I understand if I am accepted into Liberty Youth Council, I will be held to higher standard as a role model for my school, peers and community. Upon any instance, in which I use poor judgment, which violates standard Code of Conduct, I will be removed from the Liberty Youth Council immediately. By answering 'Yes' below I am committing to abiding by the Code of Conduct and by-laws set by the Council and its Advisors.
Liberty Youth Council Video/Photo Consent
I give full video and photo consent to the Liberty Youth Council to use for Council publicity.
Send me a copy of my responses.
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