Texas Oklahoma Key Leader Registration

Texas Oklahoma Key Leader Registration

Please book for the Key Leader conference by filling the form below, if have any questions please contact Chelsie Higdon at Key-leader@txokkiwanis.org
I would like to attend Key Leader as:*

Student Participant ($75)Student Facilitator ($50)Adult Chaperone ($75)Event Staff or Committee
Full Name*

First NameMiddle NameLast Name
Preferred Name (Badge Purposes)

First NameLast Name
E-mail*
Phone Number (in the event we need to reach you about registration stuff)*

Area CodePhone Number
Date of Birth*

MonthDayYear
Date
Your Address *

Street Address

Street Address Line 2

CityState

Zip Code
Gender*
T-Shirt Size*
Are you a member of?
Do you have a sponsor for this event?*
Emergency Information
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*

Area CodePhone Number
Emergency Contact Relationship To Attendee*
Do you have any special needs (Dietary, Physical Etc.) that the camp and staff should be aware of?*
If yes, please explain below:

Student Facilitator Questions

Thank you for your interest in becoming a Key Leader student facilitator. Not all applicants for the Student Facilitator may be accepted. If you are not chosen, your application will be converted to a Student Participant with an additional fee required. You will receive an e-mail from us when a decision is reached. If you have any questions, please contact District Chairperson Chelsie Higdon at Key-leader@txokkiwanis.org
Please list any leadership development events or Key Leader Events you've attended?
What have you learned from prior participation in leadership events?
Describe your Leadership Style and Past Leadership Experience
What do you hope to gain from the student facilitator experience?
Please share anything else with us you'd like us to consider.
You must be at the camp by 2 pm for student facilitator training. Are you able to meet this requirement?

YesNo

Emergency Information