AG CONFERENCE SERVICES, 430 Student Union

DUE: JUNE 15, 2017 AG CONFERENCE SERVICES, 430 Student Union ROUNDUP ADULT REGISTRATION FORM One form must be completed for each adult attending Roundup!

District County Gender

Name Work Phone

Educator Certified Volunteer “OCES Approved” Intern

Cell # Email Address

List area of interest (for assignments)

If you are in charge or have been asked to assist with an event or activity, please list below:

Event/Activity/Etc.

Dates and Times For individuals with disabilities who require auxiliary aids or services for program participation, please identify the accommodation/service needed when submitting this form. Advance notice is necessary for effective service provision; it may not be possible to provide some aids and services with late notice. Reasonable effort will be made to accommodate individuals who request auxiliary aids or services.

EACH ADULT WILL BE ASSIGNED TO ASSIST WITH ROUNDUP ACTIVITIES. Please rank top three choices per day (except Friday).

*** Rank top three choices per day*** Tractor Workshop and Contest WEDNESDAY CHOICES Land Judging Contest Rank Chai Title Job Readiness Interviews and/or Workshop r  Livestock Quiz Bowl Assist with Spotlights and AV at Assembly Clover Quiz Bowl Assist with Seating By District at Assembly Food Showdown Asst. with Technology (facebook, twitter, Educational Workshops trivia, etc).) Assist with Buses for Workshops (help Communication Contest youth and adults load) FCS Skill-a-thon Driver (MUST provide bus to workshops,/contests) ATV Safety Contest Rehearsal for 4-H Has Talent (includes Job Readiness Evaluation assisting with event on Friday) Vocal Contest Rehearsal for Honor Assembly Educational Workshops Asst. with Honor Night Seating Prior to and Assist with Buses for Workshops (help during Assembly youth and adults load) Honor Night Assembly Picnic (crowd control/monitor trash/etc.) Dance Driver (MUST provide bus to Other Evening Entertainment workshops/contests) Assist with Voting Dance Pizza Distribution Other Evening Entertainment Pizza Distribution FRIDAY CHOICES Assist with Spotlights and AV at Assembly THURSDAY CHOICES Assist with Seating By District at Assembly Assist with Spotlights and AV at Assembly Asst. with Technology (facebook, twitter, Assist with Seating By District at Assembly trivia, etc.) Asst. with Technology (facebook, twitter, 4-H Has Talent (includes rehearsal on trivia, etc).) Thursday afternoon)

(for office use only) Wednesday: Event: ______Location: ______Time: ______

Thursday: Event: ______Location: ______Time: ______

Friday: Event: ______Location: ______Time: ______