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Youth Leadership Conference Registration Form

The deadline to register for Youth Leadership Conference is Friday, June 6, 2025.

Student Name*
First Last
Parent or Guardian Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code
Parent or Guardian Phone*
Student Phone*
Student's Date of Birth*
MM slash DD slash YYYY
Gender*
Student's Email*
Parent's Email*
ACEC Account Number
Student's Grade This Upcoming Fall*
School Name*
T-Shirt Size*
How did you hear about YLC?*
Comments or concerns you'd like the chaperone to know:
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Phone
This field is for validation purposes and should be left unchanged.