A GOOD NAME Registration — Hope & Rescue Foundation

The Summit - May 13 to 15, 2016

There are three step process to register for THE SUMMIT: 1) Complete the personal information form, 2) sign the consent form and 3) make a Payment using at the bottom of this page to complete your application

1 - Registation Information

First & Last Name

First Name

Last Name

City

Address:

State

Zip

Phone

email

1st Emergency Contact Name

1st Emergency Contact Phone Number

2nd Emergency Contact Name

2nd Emergency Contact Phone Number

Medical Notes

Special Meal/Food Request

Additional Notes

2 - Consent Form

Please 1) download the consent form, 2) print it out, 3) sign, 4) have a guardian sign, and 5) bring with you to the SUMMIT.

3 - Payment Information

Make Payment - Summit