Youth first name
Youth last name
School
Grade —Please choose an option—9101112other
Youth email
Parent/Guardian email
Home Address
City
Postal Code
Parent/Guardian Telephone Number
List up to 3 careers that currently interest you (one on each line):
TERM OF AGREEMENT: This event is offered free of charge to youth. If you register and don't attend, you could be charged a $50 cancelation fee.
By checking this box, I have read the above and accept this Term of Agreement.
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