EnerStar Electric Cooperative Youth to Washington Application
If selected, the student’s social security number will only be used for building entry security purposes.
One file only.
10 MB limit.
Allowed types: gif, jpg, png, svg.
By submitting this application, I verify my eligibility to participate in the Youth Day/Tour events, including Youth Day and Youth Tour. Box must be checked by student completing application
I hereby give my consent for the above-named student to participate in the Youth Day in Springfield and the Youth Tour to Washington, D.C. if selected as a winner. Box must be checked by the parent or guardian of the above student.
By signing this application, you hereby grant your consent and permission to EnerStar Electric Cooperative and its affiliates, members, successors and assigns (“EnerStar Electric Cooperative”) to use the image(s) of the applicant. Such use includes the collection, display, disclosure, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of the applicant for use in printed and online materials including, but not limited to, brochures, magazines, and newsletters; videos and social media, including, but not limited to, EnerStar’s website, Facebook, Twitter, Instagram, and YouTube.

By submitting this application, you agree that these images may be used by EnerStar Electric Cooperative for a variety of purposes and that these images may be used without further notifying the applicant. The applicant understands that the his or her name may be used in conjunction with any video or images.