2023 Spring Jam - Scammon Bay

Student's Name

Student's Phone Number

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Birthdate

Address

Please list any medical issues, allergies, or medications

Student Travel (To/From Event)

Parent's Name

Parent's Phone Number

Parent's Email

Emergency Contact Name

Emergency Contact Number

A signed waiver by event participant or parent/guardian will be required before you can download your QR code. A link to obtain waivers for all registrants will be shown on the confirmation page.

Today's Date

Scholarship Request

If you would like to request a scholarship, please check the box. Covenant Youth of Alaska has limited financial scholarships available to help cover students travel and registration costs. All students must provide a non-refundable $25 deposit in order to request a scholarship. It is required that all students who request scholarship assistance also pursue funding from other sources first. By checking the box, you are agreeing to paying the $25 deposit and pursuing other funding sources.

Registration Total

$100.00

Coupon Code

Total

$100.00

Billing Information

Name

Credit Card

Visa
Mastercard
American Express
Discover

Address

Mobile Phone Number

Event Registration Software by RegFox

SPRING JAM

Billing Information