Alpha Phi Alpha Fraternity Inc. Beta Lambda Educational Institute “2024 HBCU College Tour” Registration Form
  • The 2024 HBCU College Tour is at Capacity
  • We are allowing students to sign up to be placed on our waiting list
  • Students will be moved from the waiting list to the active tour list as spots become available on a first come first served basis
  • In order to place your student on the waiting list, you will need to complete the online registration AND pay the $75 deposit
  • We will notify you via email if your student is moved from the waiting list to the active tour list
  • If placed on the active tour list, the remaining forms will need to be completed and funds paid by the deadlines for each
  • If your student is not moved from the waiting list to the active tour list, you will be refunded $50 of the $75 deposit
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Student First Name *
Student Last Name *
Gender *
Birth Date *
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High School *
GPA *
ACT/SAT (if Applicable)
Student Email Address *
Student Phone Number *
Student Mailing Address (Address, City, State, Zip Code) *
Counselor Name *
Counselor Email *
Counselor Telephone *
Parent/Legal Guardian First Name *
Parent/Legal Guardian Last Name
*
Parent/Legal Guardian Email *
Parent/Legal Guardian Primary Phone *
Parent/Legal Guardian Alternate Phone
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Emergency Contact 1 (Other than Parent/Legal Guardian) Name *
Emergency Contact 1 (Other than Parent/Legal Guardian) Primary Phone Number
*
Emergency Contact 2 (Other than Parent/Legal Guardian) Name
*
Emergency Contact 2 (Other than Parent/Legal Guardian) Primary Phone Number
*
List any food or medication allergies *
List any medications to be taken
*
Insurance Carrier *
Primary Card Holder *
ID# *
Policy # *

The undersigned parent/legal guardian of the above-named student hereby consents to his/her participation in the HBCU College Tour, sponsored by the Beta Lambda Educational Institute (BLEI) of Alpha Phi Alpha Fraternity, Inc. The tour will visit colleges, universities and tourist attractions during the week of March 24 – March 30, 2024.  It is understood that the tour director can, under reasonable conditions, alter the plan of this activity. However, such alterations shall involve activities or arrangements in the same general category described above.  It is also understood that in the event the parents/legal guardians have any questions regarding the plans or believe the description to be inadequate, he or she will contact the tour director to obtain additional information prior to signing this form.  The undersigned does hereby consent to the above-named student participating in the activity identified, covenants and agrees on his/her own behalf and on behalf of the student named above, not to sue and hold harmless BLEI, Beta Lambda Chapter, Alpha Phi Alpha Fraternity, Inc., and their respective boards of directors, officers, agents, volunteers, organizations or any other member for any liability, claims, actions, damages, costs or expenses incurred as a result of the student’s participation in the tour.  Furthermore, the undersigned understands that if for any reason their student must be removed from the tour for disciplinary reasons, it shall be at no expense to BLEI, and that the undersigned, and/or above-named student shall assume all costs. Nothing herein is intended to, nor shall it be construed to release any insurance company or third party from any obligation to pay under any liability insurance or other benefit.

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