Traffick JAM Student Registration

If you are a student or a parent/guardian registering a student, please continue below.

Email address *
Student's FIRST Name *
Your answer
Student's LAST Name *
Your answer
Your Phone (xxx-xxx-xxxx)
Your answer
Your Zip Code *
Your answer
Student's Age *
Your answer
School Student is Attending *
Your answer
How Did You Hear About the Conference? *
Emergency Contact Name *
Your answer
Emergency Contact Relationship *
Emergency Contact Phone (xxx-xxx-xxxx) *
Your answer
Drop Off/Pick Up
Doors open at 8:30am. Please plan to arrive before 9:00am. The conference will be at the Double Tree Hotel at 11800 108th St, Pleasant Prairie, WI 53158. Pick up time will be at 4:30pm. (Free lunch will be served. No dinner). Anyone needing to leave prior to the end of the conference who is under the age of 18 will need to be signed out in person by a parent/guardian.
Parent/Guardian Confirmation *
Concerning Allergies
FEE and the Traffick JAM are not registered allergists. If you have special needs as it relates to this area you are responsible for your own care. FEE and the Traffick JAM will not be held responsible for reactions based on allergies.
Parent/Guardian Confirmation *
Traffic JAM Release
Emergency Authorization: I give permission for my child to attend the 2018 FEE Traffick JAM in Pleasant Prarie, WI. In the event that I cannot be reached in an emergency, I hereby give permission for the leadership of FEE and/or The Traffick JAM personnel to have an authorized doctor or medical professional hospitalize, administer medical aid and treatments, order injections, anesthesia or surgery for my child at any time they believe an emergency exists. I will be responsible for all medical bills. I agree not to hold FEE, The Traffick JAM, or it’s leaders responsible for any accident should it occur.
Photo Release: I also grant permission to FEE/The Traffick JAM the right to use, reproduce, and/or distribute photographs, films, and sound recordings of my child, without compensation or approval rights, for use in materials created for purposes of promoting the activities of FEE/The Traffick JAM.

Parent/Guardian Confirmation
By typing your name below you confirm you have read and agree to the above release statement.
Parent/Guardian Name *
Your answer
We'll use this email to alert you to conference updates and changes, as well as for upcoming FEE events.
Parent/Guardian Email *
Your answer
Will a parent/guardian be attending the 1.5 hour parent session from 9a-10:30a at the conference?
If yes, how many will attend?
Your answer
Don't forget to update your calendar! See you March 17th at 9am!
A copy of your responses will be emailed to the address you provided.
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