Yearbook University™ Adviser Registration
This form must be completed by each adviser attending Yearbook University™
Name
*
First Name
Last Name
Cell Phone Number
*
Format: (000) 000-0000.
eMail Address
*
example@example.com
School Name
*
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Medical Information
Physician's Name
*
First Name
Last Name
Physician's Phone Number
*
Format: (000) 000-0000.
Medical Concerns
Please share with us if your minor has any medical concerns, such as allergies, dietary restrictions, or other information we should be aware of. Providing this information is completely voluntary and not required.
Health Insurance Provider Name
*
Insurance Policy Number
*
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Yearbook University™ Terms & Conditions
**Please Read Carefully**
Signature
*
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