Continued Registration

We are thrilled to have you join us. Here is the rest of the registration that we need to collect to make your experience the best it can be.

Parent/Guardian Contact Information

First name

Last name

Participant Information

First Name

Last Name

Participant Health Information

Any Food Allergies or Dietary Restrictions?

If YES please list any food allergies/dietary restrictions we need to be aware of

Any Non-Food Allergies?

If YES please list any non-food allergies we should be aware of.

Any Health Conditions/Concerns?

If YES please list any health conditions/concerns that we should be aware of.

Any Medications Taken Regularly?

If YES please list any medications the participant takes on a regular basis.

Would you like us to administer medication while your student artist is here?

Does the participant carry an EpiPen with them and will they bring it with them?

Does the participant have medical insurance (coverage)?

Yes

No

If no insurance is provided, I understand I am personally responsible for any medical costs that may incur.

Emergency Contact Information (other then you)

Emergency Contact #1

Emergency Contact Phone #1

Emergency Contact #2

Emergency Contact Phone #2

Group Member Requests

We do our bets to accommodate all requests of groups and housing but there is a chance that people may get split up. If you are attending the intensive with someone you would like to be with, please list thier name(s) and we will. doour best to accommodate. (Note: Males and Females will not be allowed on the same floor together.)

Choose an option

Choice #1

Please List any others

Is there anything else we need to know about the participate to help them have a successful week?

Please read the PDF's below

Terms & Conditions, Waiver and Dress Standards

www.MicDropNation.com/dress-standards

Parent/Guardian Signature (by signing you are confirming you have read and agree to our terms and conditions as well as read and agree to the waiver)

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Attendee Signature (by signing you are confirming you have read and agree to our terms and conditions as well as read and agree to the waiver)

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.

Watch your email for confirmation of registration!

Please Complete the Final Registration form.

Continued Registration

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