DNOW 2019 RUSH DNOW RUSH Registration Form Student's Name* First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Student's Age*12131415161718Date Of Birth*Gender of student*MaleFemaleStudent's Grade (choose one)*6th7th8th9th10th11th12thStudent's T-shirt size (choose one)*adult smalladult mediumadult largeadult extra-largeadult 2x-largeParent's Name* First Last Parents Address*Parent's Email Emergency Contact (name and phone number)*Is there any additional information about your student that you feel we need to know? Such as food allergies or medical conditions.I understand the cost for DNOW is:*RUSH Student $40Guest $20I need to talk about a scholarship (this information is just between the student and Chris)I (Student) agree to the following guidelines for the weekend. (You will need to check each box to confirm that you agree.)* (1) Stay with my group and agree to be transported only by them and will not leave unless I have pre-approved permission from my parents and Chris. (2) Be respectful of my host and follow their requests. (3) Pay attention and participate during the sessions and be respectful of my leaders. (4) Have an incredible time and will seek to be an example to others in all that I say and do. Parents: By typing your name in the following boxes confirms that you agree to paying the fee (Contact Chris if you need help paying the fee) and all of the rules presented to your student.* First Last Student: By typing your name in the following boxes confirms that you agree to all of the rules presented.* First Last PhoneThis field is for validation purposes and should be left unchanged.