Humboldt History Day 2018 Student Registration Form
Registration Opens: Monday, January 8
Registration Closes: Sunday, February 11 at 11:00 PM
Thank you for your interest in Humboldt History Day!
Please submit this registration online. If you have any technical difficulties, please contact Jack Bareilles at jbareilles@nohum.k12.ca.us (707-845-6546 cellular) for further instructions.
(1) Your first name *
Your answer
(2) Your last name *
Your answer
(3) Your home street address *
Your answer
(4) Your City *
Your answer
(5) Your Zip Code *
Your answer
(6) Best phone number to reach you or your parents.
Your answer
(7) Best email to reach you or your parents (if you have one).
Your answer
(8) Your grade. *
(9) Years of experience with History Day
(10) I affirm that the entry submitted for competition was researched and developed during this school year. I have read the National History Day rules and policies governing student behavior and will conform to these rules. I understand that violation of these rules may result in the disqualification of my entry. I accept the decision of the judges as final. I have reviewed and understand the information presented above and acknowledge that my participation in National History Day is conditioned on my agreement with the terms and conditions outlined herein. I further understand that selecting "Yes" for each agreement and submitting my registration shall have the same force of law as my original signature and that I am not obligated in any way to make such agreement, except as prerequisite to my participation in this program. *
(11) Parent/Guardian's First Name *
Your answer
(12) Parent/Guardian Last Name *
Your answer
(13) Parent's Cell Phone (Optional)
Your answer
(14) I understand that by agreeing, I am certifying that my student understands what is involved in participation and that I freely and voluntarily allow my student to participate and hereby agree to assume and accept any and all risks associated with his/her participation in Humboldt County History Day. *
(15) Your school *
(16) Your Teacher's First Name *
Your answer
(17) Your Teacher's Last Name *
Your answer
(18) What age division are you? *
(19) What entry category are you entering? *
(20) Website URL - enter complete URL for website entries. If you are NOT doing a website, please type: N/A *
Your answer
(21) Weebly Username for website entries
Your answer
(22) Weebly Password for website entries
Your answer
(23) Poster Title for Gr. 4-5 Posters ONLY
Your answer
(24) Entry Title for ALL Gr. 6-12 entries
Your answer
(25) Name of 2nd Group Member
Your answer
(26) Name of 3rd Group Member
Your answer
(27) Name of 4th Group Member
Your answer
(28) Name of 5th Group Member
Your answer
(29) If you will have your cell phone with you on the day of the event, please list your cell phone number (with area code).
This will allow us to text or call you the day of the event if necessary.
Your answer
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