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A.C.E.S. Workshop Information Sheet

Please contact Leesha West with any questions.

Registration is due by May 1, 2019.

All fields are required

Participant Information



Parent/Legal Guardian Information



Emergency Contact Information

   Use N/A if none.
   Use N/A if none.
   Use N/A if none.


Policy Acknowledgements

The Parent/Guardian must read and check the box for each of the policies below, indicating their agreement with each one.
  I agree to Logan's Release And Agreement To Rules.
  I agree to Logan's Emergency Medical Authorization.
  I agree to Logan's Confidentiality Statement.
  I agree to Logan's Photo and Media Release.

The Participant must read and check the box for each of the policies below, indicating their agreement with each one.
  I agree to Logan's Safety In the Laboratory.
  I agree to Logan's Confidentiality Statement.


Registration fee of $100 is required at the time of registration.
Must be paid-in-full ($750) by June 1, 2019.
You will be directed to the application fee payment site upon clicking "apply now."