We Matter Now 2024 Conference Registration

Student Name*

First NameLast Name

Student Age*

Student Grade*

8th Grade9th Grade10th Grade11th Grade

Current School Attending *

Student Phone Number*

Please enter a valid phone number.

Student Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Student T-Shirt Size*

Allergies/Dietary Restrictions

Parent / Guardian Name *

First NameLast Name

Parent / Guardian Email*

example@example.com

Parent / Guardian Phone Number*

Please enter a valid phone number.

Parent / Guardian Address (If different than student)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact Name *

First NameLast Name

Emergency Contact Phone Number*

Please enter a valid phone number.

Student transportation to conference*

Pick up/drop off @ Better Wiser Stronger, Inc (1413 Madison Ave SE GR, MI 49507)Pick up/drop off @ East Kentwood High School ( 6230 Kalamazoo Ave SE, Kentwood, MI 49508Parent Transportation to and from conference

I agree with the selected statement below:*

I grant permission for the student to participate and appear in video or audio recording, films, photographs, written articles, or on websites and social media sites for We Matter Now and affiliate groups.I do not consent to use of the students photograph, voice, and/or name in various media projects.

We Matter Now 2024 Conference Registration

Liability Release Form