Riverton Youth Council Application

Youth Information

Preferred First Name *

Last Name *

The exact name you would like printed on certificates or accolades you may receive: *

Email Address *

Cell Phone Number *

Street Address in Riverton *

Address Line 2

City *

State *

Zip Code *

Name of School You Attend *

Birthday *

Grade in School *

Unisex Shirt Size *

How did you find out about the Riverton Youth Council? *

What is your favorite treat/snack? *

Please upload one (1) letter of recommendation that supports your application to the Riverton Youth Council. (This could be from a teacher, church leader, club advisor, employer, etc.)

Please list any food or environmental allergies you have:

Parent Information

Name(s) of Parent(s)/Guardian(s) *

Parent/Guardian Email Address: *

Parent/Guardian Cell Phone Number *

Membership Agreement

In order to participate in the Riverton Youth Council, I hereby agree to the following conditions: *

I commit to attend 80% of all meetings.

I commit to attend 50% of all service projects.

I understand that by participating in the Youth Council, Riverton City reserves the right to take and use my photo for marketing purposes.

My parent(s)/guardian(s) have given me their explicit permission to participate in the Riverton Youth Council.

With my signature, I confirm the details on this application are true and correct and that I agree to all of the terms listed above required for membership on the Riverton Youth Council. *

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