Live, Virtual Show Registration
Your registration is not complete until you complete all required fields, select a show date and time, and click the SUBMIT button at the bottom of the form. If you require assistance completing the form or have any questions, please contact us at admin@eme.llc OR mbeane@roadradiousa.net
Name of School or Youth Organization
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Your Name
*
First Name
Last Name
Title
*
What is your role at your school or organization?
Phone Number
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Please enter a valid phone number.
What is the best time for Road Radio USA to contact you?
Approximately how many youth will attend this event?
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What are the ages and/or grade levels of youth who will attend this event?
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How many adults will attend this event?
*
Photo and Video Authorization
Road Radio USA uses screenshots & short videos from virtual events on our website, social media & promotional materials. This may include images of youth, staff & other individuals who attend.
Does Road Radio USA have authorization to share screenshots and videos taken during this event?
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Yes. Road Radio USA can use photos and videos from this event on the Road Radio USA website, social media, and other promotional materials.
No. Road Radio USA can NOT use photos and videos from this event on the Road Radio USA website, social media, and other promotional materials
Additional Information
Is there anything else we need to know about your school or youth organization prior to your event?
How did you hear about us?
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We'd love to know who to thank for bringing us to your school or youth organization!
Road Radio USA Newsletter Subscription Opt-In
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Yes! Please subscribe me to the Road Radio USA Newsletter
No. Please do not subscribe me to the Road Radio USA Newsletter
Use the Calendar Below to Select the Date and Time for your Virtual Show:
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Your registration is not complete until you click the submit button!
After you submit your registration, you will receive a confirmation.
Submit
Should be Empty: