2025 Alpha Project PARTICIPANT Commitment Form

This commitment form is for those who have been accepted to participate in the 2025 Alpha Project (and Alpha "E" for Elon students) jointly hosted by CO Charlotte and CO Charleston. If you have any questions, please contact your campus staff person or email charlotte@campusoutreach.org (for CO Charlotte students) or charleston@campusoutreach.org (for CO Charleston students). Thank you!

Name*

First NameLast Name

Gender*

FemaleMale

E-mail*

Cell*

School*

Do you anticipate having a car while at Alpha?*

YesNoNot sure

The Alpha Project is a unique 3-week project in which each week builds on the one before. It is crucial that we guard the continuity of the project and the environment it creates. Therefore, with the exception of emergencies, immediate family weddings, personal graduation ceremonies, and military service, no out-of-town trips are permitted. Please review the Alpha Project "Out-of-Town Policy" linked here for reference.

Please describe below the type and date(s) of any permitted out-of-town trips that you anticipate between May 12-31. If none, please type "NONE" as your indication that you will be present for the entirety of the Alpha Project.*

The vast majority of students will pay for the Alpha Project by fundraising. Please review the Alpha Project Fundraising & Cancellation Policies. This will be reviewed at your campus's fundraising training in the spring.

In summary, any cancellation request must be submitted via the Alpha Project De-Commitment Form. Cancellations made on or prior to April 5, 2025 will be subject to a $250 cancellation fee. Cancellations made after April 5, 2025 will be subject to a $500 cancellation fee. The full cancellation fee will apply regardless of any support raised at the time of de-commitment. Any funds donated towards my participation in the Alpha Project prior to my de-commitment cannot be refunded to donors due to IRS regulations.

Do you agree to the above Alpha Project Fundraising & Cancellation Policies?*

YesNo

For CO Charlotte Students: Do you plan to participate in the RISE Initiative (click link below for more info) for your fundraising process or just raise support for the Alpha Project?

RISE Initiative (Charlotte students please complete the RISE Initiative Commitment form linked below)Alpha Project onlyN/A (CO Charleston student)

CO Charlotte RISE Initiative Information

CO Charlotte RISE Initiative Commitment Form

Health Insurance Company Name*

Health Insurance Company Phone Number*

Area CodePhone Number

Name of Primary Policyholder*

Policy/Group Number*

Please describe below any special medication and/or health information that would be necessary or helpful for Alpha staff to know (i.e. relevant medical history, current medications, food/drug allergies, etc).

The undersigned hereby gives permission, in the event of an emergency, if he/she is unable to give consent or a parent/guardian cannot be reached, to the physician or dentist selected by Campus Outreach leadership to hospitalize, to secure proper treatment, and/or to order an injection, anesthesia, or surgery as deemed necessary during the program described herein.

Every activity sponsored by Campus Outreach is carefully planned and adequately supervised by mature adults; however, even with the best of planning and precaution, unforeseen events can occur. The undersigned agrees to assume and accept all risks and hazards inherent in Campus Outreach related activities. They also agree not to hold this organization or its employees liable for damages, losses, or injuries to the person or property undersigned that might arise out of, in route to/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 12-31, 2025.

This authorization, consent, and waiver of liability will remain effective, unless revoked in writing by the undersigned, and delivered to Campus Outreach.

Signature*

My Products

Alpha Project Commitment Deposit$1.00

This nominal commitment fee secures your place in the 2025 Alpha Project and serves as a backup payment method in the event of cancellation.

Total $0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Billing Address

Street Address

Street Address Line 2

CityState

Zip Code

Alpha Project 2025 Participant Commitment Form

Authorization & Consent