Exceptional Kids Livestock Show
Registration is due no later than Friday February 28, 2024
The show will take place Wednesday, March 20, 2024 at 11:00 am. Exhibitors will need to arrive at 10:30 am.
Exhibitor's Name
*
First Name
Last Name
Exhibitor's Birthday
*
-
Month
-
Day
Year
Date
Age
*
Parent's Name
*
First Name
Last Name
Parent's Email
*
example@example.com
Parent’s phone number
*
-
Area Code
Phone Number
Name of School
Grade
Doctor's Name and Phone Number
Emergency Contact Name and Phone Number
*
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Special Needs Information
This information will be used to match the exhibitor with their animal.
Allergies
*
Nature of Ability (Please list Diagnosis)
*
Does the participant use assistive devices
*
Walker
Wheelchair
Crutches
None
Other
Does the participant have seizures
*
Yes
No
T-shirt Size
*
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Release & Consent
Please make sure to read the following statements and check the boxes at the bottom. By checking the boxes, you are giving your consent and will be recognized as your electronic signature.
I have read the above and agree.*
*
Yes
No
I, The parent/guardian of the registrant, hereby give my consent for photography/videography in the use of said photographs to be displayed on website, Facebook or other means of advertisement expresly for the enrichment of the Exceptional Kids Livestock Show
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I have read the above and
Give my consent
DO NOT give my consent
Submit
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