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DOXA Lock-In; No Payment
DOXA Lock-In
When:
Friday, January 28th until Saturday, January 29th
Begins:
Registration opens at 5:00 pm Friday (dinner will be provided)
Ends:
Saturday at noon (brunch will be provided)
Cost:
$20 per teen
Teen 1
*
First
Last
Teen 1 Staying Over Night?
*
Yes
No
Teen 2
First
Last
Teen 2 Staying Over Night?
Yes
No
Teen 3
First
Last
Teen 3 Staying Over Night?
Yes
No
Allergies/Medical Conditions
For those registering more than one child, please be specific as to which child has which allergy/medical condition.
Emergency Contact Name
*
First
Last
Emergency Contact Cell Number
*
Emergency Contact Email
*
Comments or Questions
Participation Agreement
By signing below, I acknowledge that I have read, understood, and agree to the terms and conditions in the
Minor Participation
agreement, and my signature is valid and applies to all the individuals I am registering.
Signature
*
Reset signature
Signature locked. Reset to sign again
Email
This field is for validation purposes and should be left unchanged.
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