Clone of Four Way Test 2025 Student Registration Form with signatures

Four Way Test Speech Competition Student Registration 2025-2026

This form requires signatures from the student and student's parent/guardian

Important Dates

April 11	This form is due
April 25	Live semifinal judging at Glen Burnie High School - all applicants must attend
May 9	Final Speech Competition at the Comfort Inn in Bowie, Maryland

Student Information
Student's Name*

First NameLast Name
Student's Email*
example@example.com
Student's Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Name of student's high school*
Which Rotary Club are you sponsored by?*
If you selected "No sponsoring club" above, how did you hear about this contest?
Student's Acceptance of Responsibilities

I realize and accept that I am responsible to make every effort to attend the semi-finals and finals of this contest, should I qualify to do so.

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature*
Date*

MonthDayYear
Date
Parent/Guardian Information
Name*

First NameLast Name
Guardian's Email*
example@example.com
Parent/Guardian's Permission
- I am the parent or guardian of the above-named student.
- I give permission for my student to participate in this speech contest with other high school students.
- I understand that my student is responsible to attend the semi-finals and finals of the contest, if qualified to do so.
BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature*
Date*

MonthDayYear
Date
Form Due Date - April 11, 2026

For questions or assistance, please contact office@rotary7620.org
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Four Way Test Speech Competition Student Registration 2025-2026

Student Information