Bernard Buddy Jordan Foundation goes to Washington, DC
We are so happy you are interested in joining us for our Washington, DC over night trip that will be taking place on June 24 and June 25. Seating is limited and will be provided on a first come, first serve basis. Priority seating will be given to mentors and mentee. Secondary seating will be given to family members and other partner organizations.

If you are interested in attending this trip, please register so that we can plan accordingly. There may be a $25 refundable fee to reserve your seat. Refunds will be provided on the day of the trip.
Sign in to Google to save your progress. Learn more
What is your full name. *
What is the best phone number to reach you?
What is the best email address to reach you?
What is your affiliation with Bernard Buddy Jordan Foundation *
Required
Will you be traveling with a child? *
Please indicate the number of children and/or family members you will be traveling with? Please note, a maximum of 4 per household are allowed to register. *
If you are a community organization,  what is the name of your organization?
If you are a community organization, how many total individuals are interested in attending?
How many of these individuals are children (under the age of 18)?
How many of these individuals are adults/chaperones?
We will providing a t-shirt for all attendees to wear. Please indicate which sizes you will need and how many of each. (example: 1 youth small, 2 adult large, etc)
1
2
3
4
youth small
youth medium
youth large
youth xlarge
Small
Medium
Large
X Large
2 XLarge
3 XLarge
Clear selection
Will you or anyone on your team have special accommodations? *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report