2019 NPAC Eastern Regional Conference-Perfecting the HBCU Culture
October 12, 2019 at Claflin University in Orangeburg, South Carolina
Emergency Contact (Name, Phone Number)
Can you attend?
Yes, I'll be there
Sorry, can't make it
Name (First, Last)
Johnson C. Smith University
Saint Augustine University
Virginia Union University
South Carolina State University
Food Allergies (If any)
Liability Clause and Photo Release
By submitting this registration form you agree to the following message. Submission of the registration form will adhere to electronic signature privileges:
Official Statement and Photo Release
In consideration for participation at the UNCF NPAC Eastern Regional Conference, I, the undersigned student participant (if age 18 or over) or the PAC Advisor of the above named Participant, hereby release, waive, and forever discharge UNCF, N(P)AC, Claflin University, and/or their staff, students, representatives, agents, officers, and volunteers, from and against any and all liability, claims, or demands, including but not limited to all injuries, damages, or losses, which arise from or as a result of the participant’s attendance at the Conference or participation in any associated activities, including travel to and from the UNCF PAC Eastern Regional Conference (including air travel) or any events incidental to this Conference.
Photo and Written Material Release
In further consideration for allowing the above named participant to attend and participate in the conference, the undersigned does hereby give the Parties permission to capture and/or record the participant’s name, image, likeness, persona, photograph, or voice, in any media and/or technology now known or later developed. Such use of his/her name, image, likeness, persona, photograph, or voice can be used throughout the world for educational, commercial, trade, or any other lawful purpose.
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