YGPA Leadership Conference Registration Please fill out all information for the adult attending. OK Question Title * 1. First Name OK Question Title * 2. Last Name OK Question Title * 3. Your YMCA OK Question Title * 4. Your State OK Question Title * 5. Your Job Title or Role OK Question Title * 6. I am registering as: YGPA Member Youth and Government Volunteer Alliance Staff/Director Family/Friend of Attendee Other (please specify) OK Question Title * 7. Number of Years with Youth and Government or the YMCA? OK Question Title * 8. Your Email OK Question Title * 9. Cell Phone Number OK Question Title * 10. Gender OK Question Title * 11. Your Correct Pronouns She/Her He/Him Them/They Prefer not to answer (Nametag will omit this section) Please type your correct pronouns below if not on the list above OK Question Title * 12. Shirt Size Small Medium Large XL 2XL 3XL 4XL OK Question Title * 13. Emergency Contact First Name ? OK Question Title * 14. Emergency Contact Last Name ? OK Question Title * 15. Emergency Contact Best Phone Number ? OK Question Title * 16. List any allergies (Dietary/Medicinal/Environmental/etc...) ? OK Question Title * 17. Meal Requests-Please indicate if a specific meal type is requested Vegan Vegetarian Gluten Free Nut Free Lactose Free Kosher Halal Other: OK Question Title * 18. Other Dietary Requests or Restrictions ? OK Question Title * 19. Please let us know of any requests, ideas, or goals you have for the conference . OK DONE