Engineering Saturday January 19, 2019
Each GEAR UP student must complete this registration form along with a parent. Completing this form will also act as your permission for event participation. Completing this form DOES NOT GUARANTEE A SPOT FOR EVENT! You will receive confirmation of this event (see last entry below). You MUST respond to confirmation to hold your student's place. Thank you for participating in your child's post secondary planning!
Student's LAST Name *
Your answer
Student's FIRST Name *
Your answer
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. *
Your answer
Parent Email - if you don't have an email address, please answer "NONE". *
Your answer
Student cell number - if the student does not have a cell phone, please answer "NONE". *
Your answer
Type your preferred method for receiving confirmation for this event. (Text, email, or phone call) *
Your answer
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.) *
Your answer
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. *
Your answer
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