Learning to Lead

Registration

Note: Also be sure to complete this separate waiver and return it by July 1, 2014.

Guardian Information

*First name:


*Last name:


*Address:


*City:


*Zip Code:


*Phone:


*Email:


Participant:  

*First name:


*Last name:


*Date of Birth:
 (MM/DD/YYYY)   

*Grade You'll Enter in August:


*School Name:


*T-Shirt Size:


Comments:


WAIVER
I elect to attend the event for Lewis' Learning To Lead scheduled on July 23 through July 24, 2014. I, the undersigned, assigns, executors, and administrators, hereby agree to indemnify, keep and hold harmless Lewis University, their agents, officials, volunteers, and employees, from any and all claims, damages, causes of action, losses, suits, liabilities, judgments, costs and expenses (including reasonable attorney's fees and expenses), and liability imposed by law, which I may have or which may hereafter accrue to me against the University, Lewis University Administration whether or not due to the negligence or omission of the University, Lewis University Administration arising out of or connected with the Learning To Lead program. Furthermore I agree to follow and be bound by the rules and regulations as outlined in the Lewis University Handbook and all local, state, and federal laws.

REFUND POLICY
All Sales are final.

* I AGREE