The Winter Park Kappa League 2024-2025 Membership Application

The Winter Park Kappa League Membership Application - Waiting List

PLEASE NOTE: We have currently reached our maximum capacity for applications and are now hosting a waiting list. Thank you for your understanding.
Member Information
Kappa League Candidate's Name*

First NameLast Name
Date of Birth*
Grade (2024 - 2025 School Year)*
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 1 Information
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Address (If different from above)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent 2 Information
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address (If different from above)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Academics
Name of Middle/High School (2024-2025 School Year)*
Grade Point Average (GPA)
Current Courses
Please list up to 7
Course Liked the Most
Course Liked the Least
Career Aspiration
Hobbies/Interest

SingingDancingComputers/TechnologyAnimeOther
Sports

BaseballBasketballFootballLacrosseSoccerOther
Medical Information
Please list any medical conditions, allergies, or disabilities your child has that we should be made aware of:
Medical Release

In the event of an emergency and the inability of officers of the Winter Park Alumni Chapter of Kappa Alpha Psi, Fraternity, Inc. and/or Advisors of the Winter Park Kappa Leadership Development League to obtain my consent, I hereby give permission for the aforementioned officers to authorize any medical treatment or surgery which physician or surgeon shall deem necessary for my child.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
In case of emergency, which hospital or urgent care facility do you prefer to have your child transported to?
Hospital/Urgent Care
Primary Physician's Name
Photo Release

I give permission to Kappa Alpha Psi Fraternity, Inc and the Winter Park (FL) Alumni Chapter of Kappa Alpha Psi Fraternity, Inc. to use or release any photos of my child taken for the purpose of promoting the Fraternity and its Kappa League Program.
Parent/Guardian Signature*

Clear
Parent Acknowledgment

I hereby give my permission for my child to participate in the Guide Right/Kappa League Program, sponsored by the Winter Park Alumni Chapter of Kappa Alpha Psi Fraternity, Inc. I understand that the Winter Park Alumni Chapter of Kappa Alpha Psi, Inc. is not responsible for personal injury or loss of property. I am committing my child to participate in the program for at least a year, but I understand that my child is free to leave the program at any time. I agree to immediately update this application when any information changes. Additionally, I will avail myself as possible to have my child at Kappa League Meetings and events with reasonable absences.
Parent/Guardian Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty:

The Winter Park Kappa League Membership Application - Waiting List

Member Information

Parent 1 Information

Parent 2 Information

Academics

Medical Information

Medical Release

Photo Release

Parent Acknowledgment