High School LTC: June 17-20 Middle School LTC: June 21-23

  
 

LTC Registration

Please fill out the form completely and click submit to send.

I am registering for:



First Name
Last Name
Gender:
Grade in Fall of 2012:
Street Address:
City State Zip:
Phone Number:
Email Address:
School:
Have you ever attended GFI or LTC:
If yes how many times have you attended GFI and/or LTC:
Choice of Roommate:
What is your T-shirt size:
Would you be interested in carpooling or providing a ride?
Do you have any dietary restrictions?
Are you a Student Y Member?

I received Financial Assistance at KYA, Go For It, or KUNA. 
Financial assistance recipients may apply the same amount award to their LTC registration. If financial assistance was not applied for at KYA, GFI, or KUNA a student and his/her parent or guardian must fully complete the financial assistance request form and submit it to the Kentucky YMCA no later than April, 18 2012.

I would like to apply for the Pioneer Discount.

You will receive confirmation of eligibility from the Y-Staff as soon as possible.

I attended the following conference(s) without financial assistance