Co-op Youth Ambassador Application

Notice:

Our offices are closed Thursday, Dec. 18 for an All Employee Training, Wednesday, Dec. 24 and Thursday, Dec. 25 in observance of Christmas Eve and Christmas Day. We will open for normal office hours on Friday, Dec. 26 at 7:00 a.m.

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Co-op Youth Ambassador Application

First Name

Last Name

High School

Phone

Address

City/Town

State/Province

ZIP/Postal Code

Parents or Guardians

Parent/Guardian Email

Parent/Guardian Phone

Sweatshirt Size

I want to be a Youth Ambassador because:

Any medical condition(s) we should be aware of?

I agree to the following:

As the participating student, by hitting submit I agree to follow these rules: I will remain in the designated areas of all activities and will not leave the premises unless arrangements are made with the Riverland Energy staff and my parents. I understand that no alcoholic beverages or any illegal substances will be allowed. I understand that Riverland Energy may take photographs of participants and activities. I agree that Riverland Energy shall be the owner of and may use such photographs relating to the promotion of future programs. I understand that this program is strictly voluntary.