MOWW Youth Leadership Seminar (YLS) Application

MOWW Youth Leadership Seminar (YLS) Application

Sensitive Personal Information (when complete)
Note: Sensitive personal information contained in this application will be handled with extreme care and will only be used by the event director, designated event staff,medical officer or authorized medical personnel.
SUBJECT & LOCATION: LAW & ORDER

Saturday October 24, 2026, 9AM-4PM

Lynchburg PoliceConference Room

3405 Oddfellows Rd Lynchburg VA 24501

Note: Apply soon since there are limited seat available. Lunch will be provided.

STUDENT PROVIDED INFORMATION (Please type of print clearly)
Name

First NameLast Name
School
Sex
Student Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Student Email
example@example.com
Student Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
T-shirt size
S, M, L, XL
YLS events are supportive and positive learning experiences. For the event to be most beneficial to all participants each must follow the rules below.
- Be committed to participate in the entire conference as scheduled.
  * Be on time and ready to participate in each activity.
  *Get plenty of sleep before arriving at the event.
  *Set a positive example in dress, appearance, behavior and language.
  *No head-cover may be worn except where required by religious doctrine.
- Other rules that need to be mentioned will cause students to be removed.
  *Do not consume or use illegal or controlled substances including alcohol.
  *Do not smoke or vape during the event.
  *Public displays of affection(PDA), cursing, drama, arguing or fighting are not permitted.
  *Do not threaten or harm anyone.
You must read the rules above and sign below. Signing below means you will abide by these rules.
Student Signature
Student Signature Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent/Guardian Information
1. Parent/Legal Guardian Name

First NameMiddle NameLast Name
Childs Name

First NameLast Name
Relationship to Student
Parent/Guardian Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address
example@example.com
2. I/we, the undersigned being the natural parent(s) or the designated legal guardian(s) of the applying student authorize their

a. Attendance at the MOWW youth event during the specified dates cited at the top of this form.

3. I/we certify the general well-being of the student to fully participate in the event.

a. The student’s is current on his/her immunizations and vaccinations.

4. Parent/guardian responsibilities relative to the organization sponsoring the above-named student.

a. Transportation to and from the event is the responsibility of the parent or legal guardian.

b. Except for a case of substantiated gross negligence or worse, the I/we hereby release and contract to hold harmless MOWW, The event and its organizers from any and all liability and/or responsibility for the child’s welfare, well-being, and control  for the period of the seminar.

c. By my/our signature(s) hereto, I/we fully understand that we waive any and all rights whatsoever and agree not to exercise any right to make claim or to litigate against the organization listed above, in the name of the  Military Order of the World Wars.

5. Parental release of audio, visual & written material.

a. Documentary photography and audio/video recordings will be taken of the students and staff in casual, classroom, dining, and  other event activity (e.g., museum, courtroom). Additionally, group and/or individual photos will be taken.

b. Any of these photos and audio/video recordings may be published and/or used by MOWW on a MOWW web site, in the MOWW magazine, The MOWW review®, or in MOWW promotional materials. The photographer may retain copyright of such photos though unconditional release is granted to MOWW.”
Parent/Guardian Signature
Should be Empty:

MOWW Youth Leadership Seminar (YLS) Application

Parent/Guardian Information