2017 Summer Leadership Conference Registration

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Reserve your spot at one of our 2017 Summer Leadership Conferences!

A $100 non-refundable deposit is required to reserve your spot for summer conference.

FREE SWEATSHIRT: March 2 - April 1, the registration fee is $799 and you receive a FREE TACSC Hooded Sweatshirt (valued at $25)

REGULAR REGISTRATION: After April 1, regular registration of $799 applies until 2 weeks prior to each conference

LATE REGISTRATION: Anyone registering less than 2 weeks prior to a conference will incur a $100 late registration fee ($899 total)

NOTE: After you submit this registration form, you will be emailed with a confirmation of this registration and a unique Registration Number (SLC#####). Please keep this registration number for future reference.

Select the Conference Date


Please provide information for the parent submitting this Registration form

Contact Information

The following contact information is requested to follow up on registration payments if needed.
If you are a Parent, additional contact information will be requested on page 3.







Registration Type

Registration Type and Fee are updated automatically for Early Bird, Regular, and Late registration cycles.


$

Click Next Page to register your student.

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Delegate Registration

Please select the State of your student's School, and then the School.

If your student's School is NOT listed, check on the box below to enter the school's information.

Note: Schools are listed in alphabetical order, with their Cities.

Find Student's School










Do NOT enter the same email address as the parent(s). Please enter a separate email for the student or leave blank.

(To be used during conference only)











(leadership, sports, youth group, honor club)

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Depending on your selections, contact information boxes will appear below.

Contact Information for Mother or Father if needed
Mother's Contact Information




(for emergency contact during conference)





Father's Contact Information




(for emergency contact during conference)





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Please provide the student's medical information.

Medical Form Information

Write "N/A" if none

If so, please list medication, frequency, and dosage. Write "N/A" if none






Please provide two contacts for the student in the case of an emergency during the conference.

Contact Information Available For...




Additional Emergency Contacts
Enter up to two (2) additional Emergency Contacts






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Please provide any scholarship information for the student. If there are multiple scholarships, please enter all names where requested and the sum of all scholarships as the amount.

Scholarships



$
Please enter a value greater than or equal to 0.

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Subtotal
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Help Support TACSC
Can you help support TACSC and its mission to spread leadership to young students through scholarships and additional funding?

$
Would you like to purchase any TACSC Gear?
Sweatshirt (select sizes below):
Price: $25.00





Water Bottle
Price: $12.95

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Order Total
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OFFER!
Interested in a free sweatshirt? If yes, select a size below!

To Pay Immediately:

After clicking on Submit, you will need to pay for the following items immediately, if applicable:
  • Donation
  • Sweatshirts
  • Water Bottles
$

In addition, you will need to pay at least $100 towards the cost of the registration.
$
$

The total amount to be paid later is calculated as follows: TOTAL minus Total Charges Due Today
$

After you click SUBMIT, you will be taken to PayPal to submit payment for this registration
Your registration is not complete until you have submitted payment.

You will receive a confirmation email with details of this registration and a unique Registration Number (SLC#####). Please keep this registration number for future reference.

Need assistance with this form?