2021 SC YMCA Youth in Government High School Model Legislature & Court Registration Form

Welcome to SC YMCA Youth in Government!

The fall conference dates are Sunday, November 14 through Wednesday, November 17. The conference is in-person. Space is limited in order to manage distancing goals.

Students are not required to be vaccinated, nor are they required to disclose vaccination status. However, students who choose not to disclose or who are not vaccinated will be asked to provide a negative PCR test from no later than 72 hours prior to the conference and take an on-site rapid test.

Please complete this form and select your intended role. for the conference. We expect roles to fill up, so your registration date and intended role will be used to assign spots. NOTE: All first-time high school student legislators must select Premier Legislature as their role. Your previous participation in Middle School YIG does not count. Returning high school YIG student legislators will select Upper Chamber Legislature. Media and Lobbyist positions require an additional application. All other positions are open to any student.

Our Commitment to Inclusion: The Y is made up of people of all ages and from every walk of life working side by side to strengthen communities. Together we work to ensure that everyone, regardless of ability, age, cultural background, ethnicity, faith, gender, gender identity, ideology, income, national origin, race or sexual orientation has the opportunity to reach their full potential with dignity. Our core values are caring, honesty, respect and responsibility—they guide everything we do.
2021 SC YMCA Youth in Government High School Model Legislature & Court Registration Form
School/Delegation *
If your school or delegation is missing from the list, please contact Mary Capers Bledsoe @ mcbledsoe@ymcagreenville.org.
Name *

First Name Last Name
Date of Birth *

Month Day Year
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Student E-mail *

Confirmation Email
Advisor E-mail
example@example.com
Student Phone Number
Grade *
Gender
Race/Ethnicity (optional)
Country of birth (optional)
OPTIONAL: My pronouns are:
Would you like your pronouns to be listed on your nametag?
COVID Vaccine status *

This is my _______ year at the Model Legislature & Court conference. (Include Middle School participation.) *
Please select intended role for spring conference. First-year high school students, regardless of middle school participation, must select Premier Legislature - Premier House or Premier Senate - if they intend to be legislators. If you have questions about your role, please reach out to your advisor or email mcbledsoe@ymcagreenville.org

Please note that Leadership is only selected if you applied for and were selected for a leadership role in spring and summer of 2020.
Were you selected for or elected to a leadership role? *
Expected Role at this year's conference: *
Expected Leadership or Media position at this year's conference: *
Legislator Partner or Attorney Team members (if known):

Parent/Guardian Name *

First Name Last Name
Parent/Guardian Phone Number *

Area Code Phone Number
Parent/Guardian E-mail *

Confirmation Email
Parent/Guardian Place of Employment
Second Parent/Guardian Name

First Name Last Name
Second Parent/Guardian Phone Number

Area Code Phone Number
Second Parent/Guardian E-mail

Confirmation Email example@example.com
Do you have any allergies or health conditions we should be aware of?
YMCA YIG is enthusiastically non-partisan and believes every viewpoint should be heard and respected. Our delegates represent all political beliefs, and we celebrate that fact. This optional question will help us determine if our program is actually balanced, and will allow us to see trends. Please select the number that best represents how you would describe your personal political viewpoint, with 1 being the most conservative, and 8 being the most liberal/progressive. If you select "other" please describe in the next question.
If you selected "Other" please describe or elaborate
Note - A copy of your responses (excluding your pronouns) will be sent to you and your advisor.
Should be Empty: