VJAS Attendee Details

A medical emergency form (.docx) and a media release form (.docx) MUST be completed for each student in attendance. Please deliver these signed forms, along with any pending payment, at registration check in.

Name
Name of the person completing this form. Should be a group sponsor or parent of an individual member.
First Last
Email * Required
Email address of the person completing this form.
Enter Email Confirm Email
Attendee Details
Students * Required
For each student attendee registered, please indicate the following. Enter the full name of the roommate for each student.
First Name Last Name Gender Emergency Contact # (Parent) Roommate
Sponsors & Chaperones * Required
For each sponsor & chaperone registered, please indicate the following. If registrant will be in a single occupancy room, indicate SINGLE in the "Roommate" field.
First Name Last Name Roommate
Dietary Concerns
Please indicate if members of your group need considerations for the following. Catering will be notified and reasonable effort made to provide alternatives. Serious issues, such as life-threatening allergies, should also be noted by parents on medical forms.
- Vegan
- Dairy Free
- Gluten Free
- Peanut Allergy
Comments, Questions, Suggestions
Please submit any additional information, suggestions, or questions to help us best provide for a positive on-campus experience.
Comments
This field is for validation purposes and should be left unchanged.

First Name	Last Name	Gender	Emergency Contact # (Parent)	Roommate

First Name	Last Name	Roommate

Virginia Academy of Science & Virginia Junior Academy of Science

Attendee Details