Sky's the Limit Registration - YWCA Mohawk Valley

Sky's the Limit Summit Registration

*registration required

Student Information
Student Name*
First Last
Grade Level*
Student Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Student Email*
Student Phone
Parent/Guardian Information
Parent/Guardian Name*
First Last
Relationship to Student*
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Parent/Guardian Email*

All participants will need a permission slip signed by a parent and/or guardian.
Parent/Guardian Primary Phone*
Parent/Guardian Secondary Phone
Emergency Information
In the event of an emergency, if I cannot be reached, the following individuals are authorized to act on my behalf:
Name*
First Last
Phone*
Name*
First Last
Phone*
Preferred Hospital*
Physician's Name*
Physician's Phone*
Dietary Restrictions and/or Allergies*
Parent/Guardian Agreements
My child has permission to travel to, attend, and participate in Sky's the Limit activities.*
- Yes
- No
Parent/Guardian Full Name*

Including my name here serves as my legal signature, recognizing my approval for my child to attend Sky's the Limit.
Photo/Video Consent & Release*
- My student named above hereby consents to the use, reproduction, and editing by YWCA Mohawk Valley of any and all photographs and/or videos of me taken by or on behalf of YWCA MV at Sky's the Limit on Saturday, July 15. 2023. All photos are property of YWCA MV and will be retained by the agency.
Parent/Guardian Full Name*

Including my name here serves as my legal signature, recognizing the Sky's the Limit Photo/Video Consent & Release notice.
Do you want to take advantage of provided transportation?*
- Yes
- No
Free transportation will be available to and from the event. If transport is NOT needed, parent/guardian will need to confirm drop-off and pick-up times. If other adults are providing transportation, parent/guardian will need to provide YWCA MV with authorized person(s).
Name*
First Last
If transportation is not needed, please provide the name and phone number of at least one adult authorized by you to drop off and/or pick up your child.
Phone*
If transportation is not needed, please provide the name and phone number of at least one adult authorized by you to drop off and/or pick up your child.
Name
First Last
If transportation is not needed, please provide the name and phone number of at least one adult authorized by you to drop off and/or pick up your child.
Phone
If transportation is not needed, please provide the name and phone number of at least one adult authorized by you to drop off and/or pick up your child.

Sky’s the Limit Registration

Sky's the Limit Summit Registration

Student Information

Parent/Guardian Information

Emergency Information

Parent/Guardian Agreements