Conference Sign Up

1. Student's First Name (required)
2. Student's Last Name (required)
3. Parent/Guardian's Name (required)
4. Parent/Guardian's Phone

5. To receive email confirmation, please enter an email address.

   Confirmation Email Address (required)
6. Please re-enter the Confirmation Email Address (required)
7. Alternate Parent/Guardian's Name
8. Alternate Parent/Guardian's Phone

9. To receive email confirmation at an alternate email address, please enter it here.

   Alternate Confirmation Email Address
10. Please re-enter the Alternate Confirmation Email Address
11. Remember me on this device

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