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Shenp"

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rqow Sta*p/Y ofifu Con{ere'naa 20 7 3

Jur,n*I+-75,2OI
3
Exciting games and activities Barn dance - get down and boogie . Great food I Meet youth frorn others wards

Two days of service, fun and friendship for all youth ages 14-18 Painting hou$es in the communtty with support of professional painters Talent show - bring your best stuff Fireside with Max $mith

To rcgister Retum the completed parental permission and medical release form (bottom half of this fonn) to yourward Young Men orWomen Presidents by Sunday, June 9th.

Other information: o Both days start at 9am at the Stake Center-Conference ends Saturday evening. o Youth who live outside of Albany may request on the registration form to stay Friday night with a host family in one of the Albany wards. Youth talent show on Saturday night - indicate below if you would like to perform in it. o A detailed list of what to bring will be provided at a later date (by June 2nd).

Check box if you:

THE CHURCH OF

Want lodging in Albany on Friday

night tl

Will perforrn in the talent show

Parental or Guardian Permis$isn and ltiledical Release

IESUS CHruST SAINTS

OF LATTER"DAY
Farticipant
Participant s parent or guardian

lAhrd

telephone nurnber telephone number

State/Province

F&dicat ln$onnation Does the paticipant hare any of the fiolloring:

fI

Special

diet I Fslergies il

Medicati,on

[]

ChronicJRwtning illness

f]

$urgery or a serious illness in the past

year f!

Physical conditiom

thd

limit

divifV

ifyes, ex$ain belolv. Use back if more $pae is

needed-

to administer emergency treatment to the above-named participant

Parent or guardian's signature

I give permission for my child/youth to participate in the activity tiJteC ibove and authorize the adult leaders supervising this activity

for any accident or illness and to act in my stead in approYilg necessary medical care. This authorization slrall sver this activity and travel to and from this activlty.

6flS8. Printed in the USA, 33810