Special Olympics Washington | Summit Registration Form

CALENDAR

Over the Edge Spokane

Take your support of Special Olympics to new heights! Rappel June 22.

Project UNIFY Summit Registration Form

Saturday, January 26, 2012
9:00 – 3:00 p.m.

Madrona Elementary School in Edmonds (New location)
9300 236^th St. SW
Edmonds, WA 98020

Call Chara McElfish at 509-714-0211 with questions.

Fill out the form below to register.

*Name:

*Title:

*School:

*Email:

*Phone:

ie: 123-123-1234

*Group Size:

*Total Students in Group:

*Total Staff in Group:

*Staff Names & Titles:

*Student Names:

Food Allergies:

Alternate Options:

Number of Vegetarian Meals:

Number of Vegan Meals:

Number of Gluten-free Meals:

*Hotel required?

Yes No (provided if traveling over 120 miles)

Travel Info:

*Total
Female Staff:

*Total
Male Staff:

*Total
Male Students:

*Total
Female Students:

*Miles Traveling:

(from school address to VOICE address – mileage reimbursed if traveling over 60 miles)