West Side Lead Now - Student Registration

Lead Now Registration
Section 1 - Student's information

 
 
 
 
Please select one option.
Please select all that apply.
 
 
 
 
Please select one option.
 
 
Please select all that apply.
 
 
Section 2 - Information About Your Family

 
 
 
 
 
 
 
 
 
 
 
 
 
 
Section 3 - Waivers and Releases

Medical Information. To be completed by parent or legal guardian.
 
Please select one option.
 
 
 
 
Please select all that apply.
 
 
Release of Liability

 
Media Recording Release

Please select all that apply.
Student and Parent/Legal Guardian Release and Permission Signatures

I represent that I am at least 18 years of age, have read and understand the foregoing statements,
and am competent to execute this agreement. These printed name(s) are to be considered our legal signatures.
 
 
$50
 
 
 
 
 
 

Description

Lead Now Registration