High School Overnight Program Registration – Hamilton College

July 16-21 or July 23-28, 2017

Hamilton College – Clinton, NY
$997 by June 15th   |   $1,297 after June 15th

$400 down payment required at time of registration

Applicant and parent or legal guardian (if applicant is under 18 years) must read, complete, and sign this form.

Applicant's Information (Required):
First Name:
Last Name:
FemaleMale
Applicant's Email:
Date of Birth:
Day:
Year:
Home Phone:
Applicant Cell Phone:
Primary Street Address:
City:
State
Zip:
Country:

Leadership Positions Held (Not Required for Attendance):

Applicant T-Shirt Size:

Youth LargeAdult SmallAdult MediumAdult LargeAdult Extra Large

School Information (Required):
School I will represent:
Grade:
School Address:
City:
State
Zip:
Country:
School Phone:

Parent/Guardian #1 (Required):
Name:
Profession:
Work or Cell Phone:
Preferred Email:

Parent/Guardian #2:
Name:
Profession:
Work or Cell Phone:
Preferred Email:

Notes/Comments:

Select Session (Required):
Week 1 (July 16-21)Week 2 (July 23-28)

* First come, first served. No refunds will be granted, but a same-gender substitution can be made up to June 20.

 

Please register before processing online payment

Pay online:

Pay by check:

Mail check to:
Leaders for Life International
P.O. Box 44
Clinton, NY 13323