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24-01-292 CX Event Form_Release of Liability_FIN

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CAREER E XPLOR ATIONS 202 5 R E G I S T R AT I O N A N D E M E R G E N C Y/ M E D I C A L R E L E A S E F O R M

REGISTRATION INFORMATION Johnson & Wales University’s Career Explorations program offers high school students the opportunity over the course of two days of academics on a JWU campus to explore a career in one of the following areas: • Criminal Justice • Food Innovation & Technology

• Graphic Design • Health & Wellness

• Hospitality Management

Participants will experience life on campus, meet faculty, talk with current students and more. The program includes housing, all meals, instructional materials, activities and program transportation. The program will include use of on-campus labs and lab equipment.

Name of Participant

First Parent/Guardian’s Name

Gender

Home Phone Number

Date of Birth Age

Mobile/Business Phone Number

Street Address

Second Parent/Guardian’s Name

City State

Home Phone Number

ZIP

Home Phone Number

Mobile/Business Phone Number

EM E RG E N CY I N FOR M AT I O N In an emergency when parent/guardian cannot be reached, please contact the following persons:

Name

Name

Relationship

Relationship

Phone Number

Phone Number

Name

Name

Relationship

Relationship

Phone Number

Phone Number

24-01-292 12/24


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24-01-292 CX Event Form_Release of Liability_FIN by Johnson & Wales University - Issuu