2027 EC SSDC Registration

Legal Guardian and Emergency Contact Info

We will use this info for the digital permission slip signature at the end of the form, and also in case of any emergencies.
Parent/Legal Guardian Name

First NameLast Name
Relationship to Student
Parent/Legal Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Legal Guardian Email
example@example.com
My Emergency Contact is the same as my Parent/Legal Guardian.
Emergency Contact Name

First NameLast Name
Relationship to Student
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Minor Competitor

Student under the age of 18.

$20.00

Adult Competitor

Student that is 18.

$20.00

Enter coupon

Total

AEC Participant Code of Conduct
AEC Waiver Agreement and Media Release
There are no restrictions to the full rights allowed AEC or SSDC Affiliates and their trusted partners to make use of said media in any manner they deem fit, unless explicitly and specifically noted by me on the lines following this paragraph:
As the Parent or Guardian of a Minor Child (or as a Legal Adult), I give permission for AEC or SSDC Affiliates to use media that may contain my child or their likeness (or that may contain me or my likeness).
Parent/Legal Guardian Signature
Adult Competitor's Signature
Billing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

2027 East Coast SSDC Competitor Registration