Undergraduate Event Registration

Required fields are shaded in red.

General Information
First Name   A value is required.
Last Name   A value is required.
Home Phone   A value is required.Invalid format. Use the format (000) 000-0000
Emergency Phone   A value is required.Invalid format. Use the format (000) 000-0000
Email   A value is required.Invalid format.
Street Address   A value is required.
City   A value is required.
State   Please select an item.
Zipcode   A value is required.Invalid format.
High School   A value is required.
Graduation Year   A value is required.Invalid format.Minimum number of characters not met.Exceeded maximum number of characters.
Intended Major  
Number of additional people
in your party that will attend?
  A value is required.Invalid format.
Additional Information

IN THE EVENT OF AN EMERGENCY
I hereby give my consent for medical treatment to be given as may be deemed necessary by a physician in the event of injury or accident. I understand Chaminade University will not be held liable or responsible for any financial obligation incurred related to medical treatment. I understand an immediate attempt will be made to contact persons at my home residence in such an event.

Signature   A value is required.
Date   A value is required.Invalid format.

 

Signature must be by a parent or legal guardian if student is a minor, or student if 18 years of age or older.

Security Verification
Security Verification - Please retype
Listen to security code
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Please re-type the code: A value is required.Minimum number of characters not met.

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