BOLD Registration - Leadership At Its Best

Name*

First Last

Age*

Grade*

School*

Parent/Guardian Name*

Parent/Guardian Email*

Parent/Guardian Cell Phone

Have you ever attended a BOLD program in the past?

Please list any dietary restrictions:

How did you hear about our BOLD program?

I heard about BOLD programs a different way:

Consent to participate*

Yes, I agree

By checking this box, I the parent of the participant listed above give consent for my child to participate in all activities of Project BOLD Conference and BOLD Programs*

Photography Consent*

Yes, I agree

By checking this box, I hereby grant Leadership At Its Best the unrestricted right to use photographs, videotapes, digital or any other reproduction of the likeness of me and/or my child taken during the BOLD program I understand that Leadership At Its Best may publish or record these items in various manners, including, but not limited to the following: annual reports, handbooks, brochures, local television stations, community and daily newspapers, social media, web site. I acknowledge that these publications or records will be widely distributed and that Leadership At Its Best with its discretion, may release items to third parties for publication or recording. I waive any rights I may have to the items and agree to hold Leadership At Its Best harmless from any liability whatsoever rising from the use of the items.

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Email

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