The Missouri Junior Cattlemen’s Association’s Annual Show-Me Beef Leadership Conference will be held Oct. 16-18, 2015, at the MCA Headquarters in Columbia. This year’s conference theme is “Make Your Own Brand.” Young leaders will receive tips from industry experts on how to utilize their individual strengths to stand out from their peers. The conference is jam-packed with hands-on learning that takes participants beyond the office walls and onto farms and ranches throughout the state. This is also an awesome opportunity for youth to network and make lasting friendships.

The conference is open to junior members entering 8th grade through their first year of college in the school year beginning August 2015. Registration is open to the first 50 applicants and the registration fee is $100. This fee includes all meals, lodging, and transportation for the entirety of the program with the addition of a T-shirt. There will be one optional evening activity on Saturday where participants will have the option of either attending an evening tour of the old Missouri State Penitentiary or going to the movies and bowling for which they will need to bring additional spending money to use (recommend about $40).

Registration deadline is September 18. No refunds for cancellation after September 18.

Name:
Address:
City: / State: / Zip:
County: / Primary Phone:
Birth Date/Grade: / Gender (circle one): Female / Male
Email: / T-shirt Size (circle one): S M L XL
Is the applicant a paid MJCA member? □Yes □ No
If yes, please list member number ______
If no, MJCA membership is $10.
Please mail application along with health form and check to:
Missouri Cattlemen's Association
Attn: Show-Me Leadership Conference
2306 Bluff Creek Drive
Columbia, MO 65201
Make sure that all signatures and requested information on this sheet and attached sheets are filled out to the fullest extent in order to be registered for participation.
Registration Checklist:
□ $100 Registration Fee (+$10 Membership if Necessary)
(Make checks payable to: Missouri Junior Cattlemen’s Association)
□ Conference Activity and Event Acceptance
(Signed & dated)
□ Youth Health Statement and Parental Consent
(Signed & dated) /

Missouri Cattlemen's Association/Missouri Junior Cattlemen’s Association Programs

Conference Activity and Event Acceptance

Junior Leadership Conference

October 16-18, 2015

The conference is coordinated by the Missouri Junior Cattlemen's Association and the Missouri Cattlemen's Association. All participants must observe the following guidelines for conduct:

1)  Participate fully in ALL sessions.

2)  Must be able to attend the conference in full.

3)  Show respect for property and facilities used throughout the conference and assume financial responsibility for any damage caused.

4)  Observe the established schedule, including being in assigned room at the announced curfew.

5)  Cell phones will not be allowed during sessions.

6)  Appropriate and courteous behavior is expected. Swearing and obscene gestures will not be permitted. All other participants, counselors, chaperones, and guests should be treated with respect on common courtesy. Participants are expected to dress appropriately. Clothing with alcohol, tobacco, sexual connotations and other obscenities are prohibited.

7)  No alcohol, stimulants, non-prescription drugs or tobacco products will be allowed.

We, as a participant of the Junior Leadership Conference and parent/guardian, understand and accept the responsibility for following the above guidelines, and understand that failure to meet the guidelines will result in dismissal from the conference. Further, we accept financial responsibility for damages to property or materials, travel costs, and/or program costs which might result from violation of this agreement. We understand and agree that in consideration of the acceptance of to the conference, we release the Missouri Junior Cattlemen's Association, Missouri Cattlemen's Association, our county association, and their respective members and employees from all liability and loss (including court costs and attorney fees), resulting from any property damage, personal injury and bodily injury, including death, to me and my child during the course of the conference. We will be bound by all rules and regulations while participating in said events.

By signing below, you authorize the Missouri Cattlemen's Association to take pictures and sound recordings of your teen unless you provide specific instructions to the contrary, and use of the same in any form for its purposes and consent that the pictures and recordings may be copied, published, telecast or broadcast for such purposes together with descriptions and editorial statements. Your signature also states that you have read and understand the guidelines for your participation and that you take full responsibility of your actions.

Participant signature / Date
Parent/Guardian Signature / Date

Participant Acceptance:

The Show-Me Beef Leadership Conference is open to all junior members that meet the age and eligibility requirements. It is important that the conference be conducted in such a way that provides the safest possible environment for all. Every attempt will be made to work with the parents or guardians of potential participants with special health conditions or behavioral/emotional management requirements, to work out ways to involve the participant where possible. Potential participants that have medical or behavioral conditions that are beyond training, available equipment or time constraints of the conference staff may not be accepted in the conference or, they may be accepted with restrictions.

Missouri Cattlemen's Association/Missouri Junior Cattlemen’s Association Programs
Youth Health Statement and Parental Consent Form
Junior Leadership Conference
October 16-18, 2015
Participant Name
Birth date / Age / Gender: Male / Female
Social Security Number
Parental/Guardian Name
Address
City / State / Zip
Primary Phone / Cell/Home/Work
Secondary Phone / Cell/Home/Work
Email
Insurance Company Name
Group/Policy Number
Family Doctor
Office Phone / City/State
Primary Emergency Contact
Name
Relationship
Primary Phone / Cell/Home/Work
Secondary Phone / Cell/Home/Work
Secondary Emergency Contact
Name
Relationship
Primary Phone / Cell/Home/Work
Secondary Phone / Cell/Home/Work

PARENT/GUARDIAN:

PLEASE COMPLETE BACK SIDE OF PAGE.

Youth Health Statement and Parental Consent Form (continued)

Parent/Guardian – Please Complete

The following questions are asked to help provide the most appropriate care for your teen during the event. Please be as thorough as possible. If you have specific instructions or concerns that may be beyond the space provided or not covered by these questions, it is your responsibility to add extra information or get in direct contact with the Missouri Cattlemen's Association at least a month in advance of the conference.

Will your teen be bringing any type of prescribed medication to this event? □ Yes □ No
If yes, please describe:
Does your child have allergies? □ Yes □ No
If yes, please explain:
Describe any special needs (medical, physical, or mental challenges) officials should be aware of in making this program safe and accessible for your child.
Does your child have any special dietary needs? □ Yes □ No
If yes, please explain:
Latest tetanus immunization:
May your teen be given pain relievers (such as Tylenol, Ibuprofen, Motrin, etc.) □Yes □ No
Does your teen have any other restrictions or needs, not described above? □ Yes □ No
If yes, please list here:
If necessary, I do approve of officials taking my teen, ______, to the nearest doctor or hospital. I further understand that should a health problem arise, I will be notified, but that if I cannot be reached by telephone, such medical treatment, including surgery, as deemed necessary by competent medical personnel, would be rendered.
Parent/Guardian Signature / Date
Date Received (office use only):