South Shore - Marion County
Youth Leadership Program

PARENT/GUARDIAN RELEASE *

A South Shore - Marion County Youth Leadership Program is being implemented by the Marion County Cooperative Extension Service and the Marion County Leadership Team in cooperation with the three county schools and numerous other sponsors. The program was established to provide ninth grade students with the opportunity to acquire leadership training locally, to develop skills necessary to improve their school environment and to become actively involved in their communities by volunteering. Students who are chosen will be furnished transportation to the training sessions locally and out-of-town.

My child, ______________________________________, has my permission to participate in the SOUTH SHORE - MARION COUNTY YOUTH LEADERSHIP PROGRAM at a cost of $20.00 (due at the August meeting). I understand the attendance, conduct and dress requirements and agree that my child will comply. I will not hold my School District, the school board of education, any sponsoring organization, employees or members of these organizations responsible in the event my child incurs accidental injury or death while participating in the program.

* This form may be printed from your browser. If you have been selected to participate in the South Shore - Marion County Youth Leadership Team this year, please bring this signed form (and the completed Commitment Form) to the Cooperative Extension Service office in the old Health office behind the nursing home in Yellville or mail it to: Renee Myers, P.O. Box 386, Yellville, AR 72687.

Thank you. See you in August!

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