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GEMS Conference Registration Form 2018 - WAIT LIST
AT THIS TIME, OUR CONFERENCE IS FULL.  THERE IS A POSSIBILITY THAT ADDITIONAL SPOTS MAY OPEN.  IF YOU ARE INTERESTED IN BEING ADDED TO A WAITING LIST, PLEASE COMPLETE THE FOLLOWING FORM.

Please complete this form to register for the wait list for the GEMS conference at Prairie Ridge High School on January 27, 2018.  Parents are invited to participate in the college and career expo as well as the opening activity.  At 10 AM, the students will participate in small group activities.  Parents are invited to return at noon for the closing activity.  The conference will conclude at 12:30.
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Participant Information
Student Last Name *
Student First Name *
Parent/Guardian Last Name *
Parent/Guardian First Name *
Email Address *
To notify you of any changes or announcements regarding this event.
Home Address
Street Address *
City *
Zip *
Emergency Contact Information
Emergency Contact Name *
Emergency Contact Number *
School Information
School Name *
Middle School
Grade in School *
Other Info
Attended GEMS in 2016? *
Some of the sessions may involve food tasting.  Please list any food allergies for your student. *
T-shirt Size *
Photo/Video Release Statement *
By checking the box below, I authorize CHSD 155 and its schools to release student information, student works, and images publically through a variety of mediums. These include but are not limited to website stories, newsletters, social media sites, press releases, public presentations, and videos.  District 155 and its schools may release student information, student works, and images to the media for numerous reasons.  These include but are not limited to press releases and other communications with media representatives.
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