Registration | Virginia Young Democrats

Registration deadline: April 7, 2023 at 11:59pm

Registrant

First Name *

Last Name *

Pronouns

Birth Date *

Month

Day

Year

Street Address

Street Address Line 2

City

Postal Code

State/Province

Phone Number

Email *

Chapter

Please write to [email protected] if you are unable to find your chapter on the following drop-down list.

YD Chapter *

In person *

I will attend in-person or a mix of in-person and virtual

I will attend virtually ONLY

Will you be attending in-person or virtual? Note: if you are attending in-person you will be asked to provide proof of vaccination or documentation of a medical exemption. We highly encourage our unvaccinated members to attend virtually.

Convention Waiver

Please click here to read the Convention Waiver before electronically signing below. Please type your full name on the signature field.

Participant Signature *

Parent/Guardian Signature (under age 18)

Relationship to Participant (i.e. Parent, Guardian, etc)

ActBlue Registration Fee Receipt *

Please provide the reference number from your ActBlue receipt to verify your registration fee. The number should begin with "AB". If you have been granted a waiver, provide your waiver code instead. Still need to pay the registration fee? Click here to pay your registration fee.