VOX808 – REGISTRATION

*Waiver Form (please read and sign below)

First Name(required)

Last Name(required)

Birthday and Age (required)

Email Address (If no email address, write NONE)(required)

Mobile phone number (if no personal phone, write NONE)(required)

Parent/Guardian First Name (required)

Parent/Guardian Last Name (required)

Parent/Guardian email address (required)

Parent/Guardian Mobile Phone (required)

Home Address(required)

Home Phone - if applicable

Emergency Contact Info. - Name, Relationship, Phone no.(required)

Additional Comments

Medicine or Food Allergies? (please list)

Cast Member T-Shirt Size(required)

School and Grade Level(required)

*after pressing Submit, “message sent” will appear, along with a review of your answers.
If not, please check all required areas carefully and submit again. If any problems, please contact Dane Ison (YPAC808 Director) at ypac808@gmail.com

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