Co-op Youth Ambassador Application | Riverland Energy Cooperative

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

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

I want to be a Youth Ambassador because:

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 relinquish all rights that I may claim in relation to use of said photographs. I understand that due to Covid-19, this program will be modified to provide a safe environment for students and may be canceled at any time.

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