Summer Academy Master 2024 Registration

Participant Information

First Name *

Last Name *

Mobile

Email Address *

Street Address *

Unit number or C/O

Country

State *

City *

Zip *

Save Profile

Password *

Confirm Password *

Birthdate

Grade in 23-24

CBC produces marketing/informational brochures, advertisements, and newsletters. Signing this form authorizes the school to utilize photographs and/or video in future marketing materials, CBC E-news Letters, Features, and various other types of media. The Permission is granted for the above participant.Permission is NOT granted for the above participant

I grant permission to Christian Brothers College High School to provide transportation for the above participant to and from off campus activities. Permission for Transportation at Summer Academy is granted for the above participant.Permission for Transportation at Summer Academy is NOT granted to the above participant.

School:

CBC Summer Academy Medical/Emergency Release

Please choose a treatment option: I give permission to Christian Brothers College High School for such medical operative procedures as may be deemed necessary for the above participant. This permit shall continue full force and effect until revoked in writing delivered to the Business Office of Christian Brothers College High School.If injured or ill, the above participant is NOT to recieve medical treatment until I have given my express consent.

Significant Medical Facts or Allergies for the above participant

Parent/Guardian Digital Signature *

The law requires that parental permission be obtained for certain medical and operative procedures on minors. The following consent form should be signed by the parents or guardians so that emergency medical procedures may be promptly carried out and so that no unnecessary delays will occur with less urgent medical and operative procedures or situations which may occur or exist. HOWEVER, NO OPERATION OTHER THAN MINOR SURGERY WILL BE PERFORMED, EXCEPT IN AN EXTREME EMERGENCY, WITHOUT MAKING REASONABLE EFFORT FOR PARENTS OR GUARDIANS BEING CONTACTED AND FULLY INFORMED. PARENT/GUARDIAN SIGNATURE REQUIRED.

Payment Information

Name on Card *

Card Number *

Expiration *

CVV *

Country

Zip *

Summer Academy Master 2024 Registration

Program Selection

Parent/Guardian Information

Participant Information

CBC Summer Academy Medical/Emergency Release

Payment Information

Verify OTP