GVS and WorldQuest Registration
Please complete and submit this form to register for PAAC's Global Vision Summit.

In addition to submitting this registration form, please don't forget to send in your registration fee. The fee is $5 per student and covers lunch and a small gift (teachers/chaperones are free).

Payment can be made by sending cash or check to PAAC at 1601 East-West Rd, 4th Flr, Honolulu, HI 96848. Checks should be payable to "PAAC". You can also pay online at https://www.paachawaii.org/GVS20. If the fee is a financial hardship please contact hs@paachawaii.org.

The fee is waived for all PAAC After-School Class students.
Email address *
Full Name *
Your answer
School *
Your answer
Grade *
Teacher Chaperone *
All students must have a teacher or adult present who acts as their chaperone. If you do not have a teacher chaperone or an adult who is willing to be your chaperone, please contact PAAC at hs@paachawaii.org to inquire about options.
Your answer
Lunch is included with the $5 registration fee. Check which you prefer *
Required
Emergency Information
In case of emergency, please provide the following information.
Full Name of Emergency Contact *
Your answer
Relationship of Emergency Contact to Student *
e.g. Father
Your answer
Emergency Contact Phone Number *
Your answer
Health Plan/Insurance Company of Student
Please also include account number. You may need to ask your parent/guardian for this information.
Your answer
For Students
While participating in PAAC activities, behavior consistent with PAAC’s goals and image is expected. All students are expected to follow the school rules outlined in Chapter 19 concerning student conduct and general behavior by the Hawaii State Department of Education. Failure to do so will result in your being sent home, potentially at your own expense.
Student Signature *
By typing my name, I agree to the above conditions and agree to abide by them.
Your answer
Today's Date *
MM
/
DD
/
YYYY
For Parents/Guardians
I hereby approve the participation of my child in PAAC’s statewide high school program. I understand that the PAAC staff will provide information regarding each activity to my child via the PAAC Club advisor or After-School Class teacher in his/her school. It is the responsibility of my child to inform me of the dates and venues of these events.

I expressly waive any and all claims against the Pacific and Asian Affairs Council (PAAC) and the Department of Education (DOE), their respective board members, employees, agents, representatives and successors, arising from or in connection with any accident, injury, illness, or other damage that may be incurred by the aforementioned student or said person’s property in connection with or incident to his/her attendance at PAAC events, including travel to and from PAAC activities.

I authorize the medical treatment of the student named above by any licensed physician in the event of a medical emergency.

I also consent to allow photographs of my child participating in PAAC activities be used for publicity or grant reporting purposes (for example, on the PAAC web page or in annual reports). I understand that newspaper or television media may be present at this event. I give permission for my child to appear in the newspaper or on television.
Parent/Guardian signature *
By typing my name, I certify that I am the parent/guardian of the student listed above and I agree to the above statements.
Your answer
Today's Date *
MM
/
DD
/
YYYY
Next
Never submit passwords through Google Forms.
This form was created inside of Pacific & Asian Affairs Council. Report Abuse