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College Caravan
FSU ( Tallahassee) ~ UF (Gainesville) ~ UCF (Orlando)
Monday, November 1st - Tuesday, November 2nd, 2010

$200.00 per Student - Click here for Itinerary

Student's Name:
Address:
City, State Zip:   

Parent Cell:

Parent Email:
Student Cell:
Student Email:
School
Grade
Insurance
Policy Number
Insurance Phone Number
Allergies
Medications

By completing this Registration Form, I give my permission for my child, , to participate in CKT’s College Caravan. I hold harmless Congregation Kol Tikvah, The Youth Department and/or individual Advisors that may be part of this trip if any injuries may incur in transit to/from or during the event. I give Congregation Kol Tikvah, or an agent of Congregation Kol Tikvah in an advisor capacity for the Youth Department, permission to have my child treated at a medical facility in the event of a medical emergency and I cannot be contacted. I give Congregation Kol Tikvah permission to use and publish any photographs of my child from the event.