Engineering Event, Saturday, Sept. 20, 2018
Each GEAR UP student must complete this form along with a parent. This form will act as your registration and your permission to participate. You will receive an email or text message confirming your spot in the experience. You must respond to hold your place.
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Student's LAST Name *
Student's FIRST Name *
School *
Parent Cell Number - It is important that we have a number to reach you, in case of an emergency, when your child is attending a GEAR UP event. *
Parent Email - if you don't have an email address, please answer "NONE". *
Student cell number - if the student does not have a cell phone, please answer "NONE". *
Please explain any medical or dietary needs that your child may have or print "NONE". (If daily medicine is required during this time span, then a parent will need to be present to administer.) *
GEAR UP uses photos and video to capture our events in order to highlight the program and its goals. Please check the box below to confirm that you understand that your child may appear in a picture or video for the GEAR UP Program. *
Required
Parents, please type your FIRST AND LAST NAME below to confirm that you are giving your child permission to participate. *
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