Champion Gardeners Youth Entrepreneurs Registration Form

Champion Gardeners Youth Entrepreneurs Registration Form

Register to Become A Champion Gardener Today
Your Name:*

First NameLast Name
Birth Date:*

MonthDayYear
Age
Home Phone Number:*

Area CodePhone Number
Mobile Number:

Area CodePhone Number
Email Address:*
Primary Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Select Camp shirt size:*

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Please provide any medical or dietary restrictions you have:
How did you hear about Champion Gardeners Youth Entrepreneurs (CGYE)?:*

Your Reason For Joining Champion Gardeners Youth Entrepreneurs
In 300 words or less, please describe your reasons for wishing to attend this camp.

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CGYE Media Release Form
I First and Last Name hereby authorize this organization to use my photo, video, and likeness for the purpose of promotion in news releases, photographs, video, audio, website, marketing and advertising for an indefinite period of time.

If I am under the age of 18, my undersigned parent or legal guardian is executing this release on my behalf and agrees to be bound by its terms.
Parent/Guardian Name

First NameLast Name
Parent/Guardian Signature

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Should be Empty:

Your Reason For Joining Champion Gardeners Youth Entrepreneurs