Student Registration Form

This conference is open to students in Lee, Collier, Charlotte, Manatee, Sarasota and Hendry counties, Florida. Attendance is limited. Only 5 students per school.

Please fill out the student registration form. Once you have submitted the form, you will be prompted to download a parental permission form. Fill it out and email it to lynne_kimmich@afgfl.com.

The registration form and the parent permission forms must be submitted before students can participate.

If you have any questions, please email Lynne_Kimmich@afgfl.com.

Name:

First

Last

Age:

Address:

Street Address Street Address Line 2 City State / Province / Region Postal / Zip Code Country

E-mail:

Phone:

Area Code

-

Phone Number

School name: