W&J Admitted Student Connection

*Required Field

BIOGRAPHICAL INFORMATION

*First Name

*Last Name

*Email Address

*Student Birthdate

What meal would you like?

Chicken

Fish

Pasta

Please list any allergies you may have:

SCHOOL INFORMATION

*Entry Term

*Search for your high school (If your school does not appear in the first drop menu, click “Continued…” at the bottom of the list.)

School CEEB code (Hidden)

T-Shirt Size

GUEST INFORMATION

Due to space limitations, please note that registration is limited to 2 guests per student. Thank you for understanding!

*Would you like to bring a guest?

GUEST ONE

Guest Type

Guest First Name

Guest Last Name

Guest Email

What meal would you like?

Chicken

Fish

Pasta

Please list any allergies for Guest 1:

GUEST TWO

Guest Type

Second Guest First Name

Second Guest Last Name

Second Guest Email

What meal would you like?

Chicken

Fish

Pasta

Please list any allergies for Guest 2:

Please note, we do have limited space, so reservations are limited 2 guests per student. Thank you!

ACCESSIBILITY NEEDS

Do you or any of your guests require accommodations or accessibility support to participate fully in this event?

Dietary

Physical Mobility Assistance

Transportation Assistance

Other

Please explain your accessibility request below:

PUBLICITY RELEASE FORM

I hereby grant permission to Washington & Jefferson College (W&J) to use my photograph, image, video, recording, and/or audio recording (the “Likeness”) in its printed materials, advertising, on its website, social media presences, elsewhere on the internet, or in newspaper or other printed publications without further consideration. I agree that my Likeness may be distributed nationally or internationally.
I agree that W&J may crop or edit the Likeness at its discretion, and hereby waive my right to inspect or approve any raw or edited versions of the Likeness.
I agree that W&J may choose not to use the Likeness at this time, but may do so at its discretion at a later date. I agree that permission to use the Likeness granted under this Release Form does not expire, and that the Likeness may be used by W&J in perpetuity.
I agree that once the Likeness is posted on the internet, W&J assumes no liability for the activities of third parties, and W&J may police the use of the Likeness by third parties at its own discretion.
I hereby waive my right to any share of any royalties or other compensation arising from W&J’s use of the Likeness.
Therefore, I agree to indemnify and hold harmless W&J, its Board of Directors, and its employees, administrators, affiliates, agents, and assignees from any and all claims, damages, causes of action, and liability related to or arising from use of the Likeness by W&J or unauthorized third parties.

Acknowledgement

I agree

I disagree