KEY LEADER Registration (AL18)
This form registers you for the 2018 Key Leader Weekend. Upon completion, you will receive and an email confirmation and invoice, as well as a detailed packet of information. Your registration is not COMPLETE until payment is received. Payment can be mailed to Alabama Kiwanis | Attn: KEY LEADER | PO Box 59426 | Birmingham, AL 35259 Questions: Contact Jamie.M.Brabston@gmail.com
Participant Name *
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Participant Address *
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Participant Email
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Participant Date of Birth *
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Participant High School *
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Current Key Club Member? *
Required
Participant Sponsor (if applicable) Ex. Key Club or Kiwanis Club assisting with payment
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Please list any participant health concerns, allergies, or dietary restrictions. If none, type NONE. *
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Parent/ Guardian Name *
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Parent Address (if different)
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Parent/Guardian Email
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Parent/ Guardian Phone Number *
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Second Emergency Contact Name and Phone Number *
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Name and Email to Invoice *
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