ALPHA Project Commitment Form 2023

ALPHA Project 2024

Monday, May 13th - Friday, May 31st
Full Name*

First NameLast Name
Gender*

FemaleMale
School*

Liberty UniversityUniversity of LynchburgUniversity of VirginiaRandolph CollegeOther
E-mail*
Please use the same email from your application
Cell*

Area CodePhone Number
Do you have any food allergies or dietary restrictions?
Where will you be coming to ALPHA from (city and state)?*
Will you have a car at ALPHA Project?*

YesNo
T-shirt Size

SmallMediumLargeX LargeXX Large
Out of Town Policy

The Alpha Project is a unique life-giving leadership intensive. It will take place between Monday, May 13th and Friday, May 31st. The daily schedule and progression of content is planned in a way that maximizes the learning and enjoyment of each Alpha Project participant. Therefore, it is crucial that we put out of town guidelines in place to maximize the experience for each individual.
I have read the Out-of-Town Policy and am willing to comply with it:*

YesNo
Will you need to come late to the project or leave early?*

YesNo
Please provide dates and an explanation. Also, please inform your campus staff so they can seek approval from the Project Director(s).
Authorization & Consent

Completion of this commitment form indicates that you have read and agree to follow the Alpha Project Guidelines and financial policies.

The majority of students will pay for Alpha Project by raising support. The total cost of Alpha Project is $1,350. A $100 deposit is due at the completion of this commitment form, and $600 (via personal payment or support raised) is due by May 1st, 2024 The remaining $650 (via personal payment or support raised) by May 31st, 2024.

Upon signing this commitment form we will reserve a place for you in the beach houses for the 2024 Alpha Project. Once a commitment is made, you are obligated to the full cost of the Alpha Project, even if you later are unable or decide not to attend.
Are you willing to attend a support raising information meeting and work towards securing 100% of the ALPHA Project cost by May 31st?*

YesNo
Please describe any special medications and/or medical information that would be necessary or helpful to know.
The undersigned hereby authorizes Campus Outreach Washington D.C. and Lynchburg to seek professional medical attention if deemed necessary for the above student during the program described herein.

Further, the undersigned agrees that Campus Outreach Washington D.C. and Lynchburg or any subdivision thereof, shall be held harmless from and indemnified by student against any liability for damages to person or property of the student named herein that might arise out of in route to, in route from, while in residence, or as a result of any involvement or participation by said student in the program described as the Alpha Project from May 13th-May 31st, 2024

This authorization, consent, and waiver of liability will remain effective, unless revoked in writing by the undersigned, and delivered to Campus Outreach Washington D.C., and Lynchburg.
Electronic Signature*
Please type your full name
In order to confirm your commitment to the ALPHA Project a $100 non-refundable deposit is required. This deposit will secure your spot at Alpha and will count toward your overall ALPHA cost.

Commitment Fee:

ALPHA Project Commitment Fee$100.00

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Total $0.00

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ALPHA Project 2024